Service Area|Px Code|Procedure Description|Alternate CPT/HCPCS Code|Alternate Identification|Alternate Code by Location|Alternate Code by Department|Fee Schedule Group Name|Unit Price
WS SERVICE AREA|93010337|Hc Cto Des Stent Lc/lcx|92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010335|Hc Cto Des Stent Ld/lad|92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010341|Hc Cto Des Stent Lm Artery|92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010339|Hc Cto Des Stent Rc/rca|92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010343|Hc Cto Des Stent Ramus Artery|92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943,92943|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010347|Hc Cto Des Stent Addl Brch Lc/lcx|92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|25,781.00
WS SERVICE AREA|93010345|Hc Cto Des Stent Addl Brch Ld/lad|92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|25,781.00
WS SERVICE AREA|93010349|Hc Cto Des Stent Addl Brch Rc/rca|92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944,92944|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|25,781.00
WS SERVICE AREA|70300060|HC MR ANGIO ABDDOMEN W/O CONTRAST|74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|3,215.00
WS SERVICE AREA|70300061|Hc Mr Angio Abdomen W+w/o Contrast|74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185,74185|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|4,581.00
WS SERVICE AREA|93292929|Hc Robitic Asst Stent Des Rc/rca Additional Branch|92929,92929|24101,24102|,|,|WS HB DEFAULT|6,101.00
WS SERVICE AREA|70300064|Hc Mri Breast Unilateral W+w/o Contrast|77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048,77048|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|4,037.00
WS SERVICE AREA|70300067|Hc Mri Breast Bilateral W+w/o Contrast|77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049,77049|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|5,447.00
WS SERVICE AREA|70300068|Hc Mr Angio Chest W/o Contrast|71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|3,108.00
WS SERVICE AREA|70300069|Hc Mr Angio Chest W+w/o Contrast|71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555,71555|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|5,015.00
WS SERVICE AREA|70300070|Hc Mr Angio Lower Extremity W/o Contrast|73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|2,686.00
WS SERVICE AREA|70300071|Hc Mr Angio Lower  Extremity W+w/o Contrast|73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725,73725|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|2,912.00
WS SERVICE AREA|70300072|Hc Mr Angio Pelvis W/o Contrast|72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|3,271.00
WS SERVICE AREA|70300073|Hc Mr Angio Pelvis W+w/o Contrast|72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198,72198|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|3,918.00
WS SERVICE AREA|70600018|Hc Screening Mammography Bi 2-view Breast Inc Cad|G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202,G0202|20201,20202,20501,20502,21201,21202,21203,21401,21601,22301,22302,23201,23202,23203,23501,24101,24102,24201,24203,24204,24205,24301,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,26906,27401,27402,27501,27901,30201,30301,30302,31601,33402,34801,34901,35701,35702|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|933.00
WS SERVICE AREA|70677061|Hc Breast Tomosynthesis Diagnostic Digital Uni|G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279,G0279|20201,20202,21201,21202,21203,21401,22301,22302,23201,23202,23203,23501,24101,24201,24203,24301,24402,24701,26001,26702,26901,26902,26903,26904,26905,26906,27501,27901,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|120.00
WS SERVICE AREA|93592933|Hc Robotic Asst Atherectomy And Des Stent Ld/lad|92933,92933|24101,24102|,|,|WS HB DEFAULT|23,604.00
WS SERVICE AREA|80085082|Hc Onc(breast), Mrna, Microarray Gene Expression Prof Of 70 Content Genes And 465 Hk Genes|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20201,20202,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,2421,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,24402,26702,26906|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|8,194.00
WS SERVICE AREA|80085072|Hc Amphetamines 3 Or 4|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|218.00
WS SERVICE AREA|80085071|Hc Drug Screening Barbiturates|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|146.00
WS SERVICE AREA|70372159|Hc Mr Angio Spine W+w/o Contrast|72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159,72159|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|3,918.00
WS SERVICE AREA|80085074|Hc Antidepressants Class 6/more|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|115.00
WS SERVICE AREA|80085075|Hc Antiepileptics Nos 7/more|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|115.00
WS SERVICE AREA|80085076|Hc Antipsychotics Nos 7/more|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|115.00
WS SERVICE AREA|80085077|Hc Stimulants Synthetic|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|115.00
WS SERVICE AREA|80085078|Hc Chloramphenicol|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|131.00
WS SERVICE AREA|80085079|Hc Quinine|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20102,20105,20107,20109,20201,20202,20502,21201,21202,21203,21204,21501,21601,21701,21702,21703,21704,21706,21707,21708,21709,21713,22301,23101,23102,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27402,27501,27901,30301,31601,33201,33402,34801,34901,35501,35502,39701,45101|||WS HB DEFAULT|131.00
WS SERVICE AREA|93692933|Hc Robotic Asst Atherectomy Des Stent Lc/lcx|92933,92933|24101,24102|,|,|WS HB DEFAULT|23,604.00
WS SERVICE AREA|10010227|Hc Lc Apply Skn Sub Grft Trunk/arm/leg <100 Sqcm|15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271,15271|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|2,040.00
WS SERVICE AREA|10010229|Hc Lc Apply Chld Skn Sub Grft Trunk/arm/leg <100 Sqcm|15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273,15273|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|2,040.00
WS SERVICE AREA|10010222|Hc Lc Apply Chld Skn Sub Grft Trunk/arm/leg Ea Add <100 Sqcm|15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274,15274|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|869.00
WS SERVICE AREA|10010223|Hc Lc Apply Skn Sub Grft Face/nk/h-f/g <100 Sqcm|15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275,15275|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|2,040.00
WS SERVICE AREA|10010224|Hc Lc Apply Skn Sub Grft Face/nk/h-f/g Ea Add <100 Sqcm|15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276,15276|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|934.00
WS SERVICE AREA|10010225|Hc Lc Apply Chld Skn Sub Grft Face/nk/h-f/g <100 Sqcm|15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277,15277|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|2,040.00
WS SERVICE AREA|10010226|Hc Lc Apply Chld Skn Sub Grft Face/nk/h-f/g Ea Add <100 Sqcm|15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278,15278|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|869.00
WS SERVICE AREA|10010228|Hc Lc Apply Skin Sub Grft Trunk/arm/leg Ea Add <100 Sqcm|15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272,15272|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|869.00
WS SERVICE AREA|93010364|Hc Graft Ptca And/or Des Stent Ramus Artery|92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|22,289.00
WS SERVICE AREA|27800276|Hc Nm Sir-spheres Y-90 Brachy|S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095,S2095|20701,20702,20703,20704,20705,20801,20901,21001,21103,21104,21105,21106,21107,21108,21109,21110,21111,21112,21113,21114,21115,21116,21117,21118,21119,21120,21121,21122,21123,21124,21125,21126,21128,21129,21130,21131,21132,21133,21134,21135,21136,21301,21701,21702,21703,21704,21706,21707,21708,21709,21711,21712,21713,21714,21901,22001,22101,22202,22203,22205,22402,22403,22801,22803,23002,23101,23102,23104,23301,23302,23304,23401,23402,23403,23404,23405,23801,23802,23901,23902,24003,24004,24401,24402,24501,24502,24503,24504,24601,24801,24802,25001,25201,26301,26302,26303,26401,26601,26701,26702,26801,26803,26805,26806,26807,26808,26809,26810,26812,26813,26814,26815,26816,26817,26818,26819,27801,27802,27803,27804,27805,28702,28802,29401,29501,29601,29701,29801,29901,30001,30101,30901,31001,31201,31301,31401,31501,31701,31801,32901,33001,33502,34501,34701,34702,35901,36501,37901,38001,38002,38101,38201,38301,38601,38901,39001,39201,39301,39401,39501,39801,45001,46301,46401,46501,46601,46602,46603,48901,49001,50101,50201,50301,50401,50501,50601,50701,50801,50901,51001,99801,99901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|77,696.00
WS SERVICE AREA|93792933|Hc Robotic Asst Atherectomy And Des Stent Rc/rca|92933,92933|24101,24102|,|,|WS HB DEFAULT|23,604.00
WS SERVICE AREA|97060052|HC ELEC STIM OTHER THAN WOUND 1 OR MORE AREAS|97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014|20201,20202,21201,21202,21203,21204,21401,22301,23201,23202,23203,23501,24201,24202,24203,24301,24302,24303,26001,26901,26902,26903,26904,26905,27001,27501,27901,28101,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|284.00
WS SERVICE AREA|77010097|Hc Intensity Modulated Rad Tx (imrt) Simple|G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015,G6015|20501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,27402|||WS HB DEFAULT|6,102.00
WS SERVICE AREA|77010098|Hc Intensity Modulated Rad Tx (imrt) Complex|G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016,G6016|20501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,27402|||WS HB DEFAULT|6,514.00
WS SERVICE AREA|80084637|Hc Antidepressant Tricyclic 1/2|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20201,20202,20501,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27401,27402,27501,27901,30301,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|276.00
WS SERVICE AREA|80084638|Hc Benzodiazepines 1-12|G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483,G0483|20201,20202,20501,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27401,27402,27501,27901,30301,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|244.00
WS SERVICE AREA|80020315|Hc Surg Path Gross And Micro Prostate Bx, Any Mthd|88305|21109|||WS HB DEFAULT|802.00
WS SERVICE AREA|93892933|Hc Robotic Asst Atherectomy And Des Stent Lm Artery|92933,92933|24101,24102|,|,|WS HB DEFAULT|23,604.00
WS SERVICE AREA|93992933|Hc Robotic Asst Atherectomy And Des Stent Ramus Artery|92933,92933|24101,24102|,|,|WS HB DEFAULT|23,604.00
WS SERVICE AREA|93392934|Hc Robotic Asst Atherectomy Des Stent Additional Ld/lad|92934,92934|24101,24102|,|,|WS HB DEFAULT|17,512.00
WS SERVICE AREA|93492934|Hc Robotic Asst Atherectomy Des Stent Additional Lc/lcx|92934,92934|24101,24102|,|,|WS HB DEFAULT|17,512.00
WS SERVICE AREA|93592934|Hc Robotic Asst Atherectomy Des Stent Additional Rc/rca|92934,92934|24101,24102|,|,|WS HB DEFAULT|17,512.00
WS SERVICE AREA|93392937|Hc Robotic Asst Graft Ptca And Des Stent To Ld/lad|92937,92937|24101,24102|,|,|WS HB DEFAULT|24,518.00
WS SERVICE AREA|80080445|Hc Drug Screening Fentanyl|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20101,20107,20108,20201,20202,20502,21201,21202,21203,21204,21501,21601,22301,22302,23103,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24402,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26702,26901,26902,26903,26904,26905,26906,27001,27401,27402,27501,27901,30301,30501,30502,30503,30504,30505,30506,30507,30508,30510,30511,30512,30513,30514,30515,31601,33201,33402,34801,34901,35701,39701,48001,48101,50001,50002,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|248.00
WS SERVICE AREA|93492937|Hc Robotic Asst Graft Ptca And Des Stent To Lc/lcx|92937,92937|24101,24102|,|,|WS HB DEFAULT|24,518.00
WS SERVICE AREA|93592937|Hc Robotic Asst Graft Ptca And Des Stent To Rc/rca|92937,92937|24101,24102|,|,|WS HB DEFAULT|24,518.00
WS SERVICE AREA|93792937|Hc Robotic Asst Graft Ptca And/or Des Stent Ramus Artery|92937,92937|24101,24102|,|,|WS HB DEFAULT|24,518.00
WS SERVICE AREA|93092938|Hc  Robotic Asst Graft Ptca And/or Des Stent Addtl Ld/lad|92938,92938|24101,24102|,|,|WS HB DEFAULT|18,425.00
WS SERVICE AREA|93492938|Hc  Robotic Asst Graft Ptca And/or Des Stent Addtl Lc/lcx|92938,92938|24101,24102|,|,|WS HB DEFAULT|18,425.00
WS SERVICE AREA|93592938|Hc  Robotic Asst Graft Ptca And/or Des Stent Addtl Rc/rca|92938,92938|24101,24102|,|,|WS HB DEFAULT|18,425.00
WS SERVICE AREA|93192941|Hc Ip Only-robotic Asst Prq Card Des Revasc Mi 1vsl Ld|92941,92941|24101,24102|,|,|WS HB DEFAULT|34,323.00
WS SERVICE AREA|93392941|Hc Ip Only-robotic Asst Prq Card Des Revasc Mi 1vsl Lc|92941,92941|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93492941|Hc Ip Only-robotic Asst Prq Card Des Revasc Mi 1vsl Rc|92941,92941|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93792941|Hc Ip Only- Robotic Asst Prq Card Des Revasc Mi 1vsl Lm|92941,92941|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|90192929|Hc Robotic  Asst Stent Bms Lc/lcx Additional Branch|92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|6,101.00
WS SERVICE AREA|93992941|Hc Ip Only-robotic Asst Prq Card Des Revasc Mi 1vsl Ri|92941,92941|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93192943|Hc Robotic Asst Cto Des Stent Ld/lad|92943,92943|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93392943|Hc Robotic Asst Cto Des Stent Lc/lcx|92943,92943|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93592943|Hc Robotic Asst Cto Des Stent Rc/rca|92943,92943|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93792943|Hc Robotic Asst Cto Des Stent Lm Artery|92943,92943|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93992943|Hc Robotic Asst Cto Des Stent Ramus Artery|92943,92943|24101,24102|,|,|WS HB DEFAULT|34,452.00
WS SERVICE AREA|93192944|Hc Robotic Asst Cto Des Stent Addl Brch Ld/lad|92944,92944|24101,24102|,|,|WS HB DEFAULT|28,359.00
WS SERVICE AREA|93392944|Hc Robotic Asst Cto Des Stent Addl Brch Lc/lcx|92944,92944|24101,24102|,|,|WS HB DEFAULT|28,359.00
WS SERVICE AREA|93592944|Hc Robotic Asst Cto Des Stent Addl Brch Rc/rca|92944,92944|24101,24102|,|,|WS HB DEFAULT|28,359.00
WS SERVICE AREA|93008921|Hc  Tte W Or W/o Fol W/cont, Com|93303,93303|24101,24102|,|,|WS HB DEFAULT|2,706.00
WS SERVICE AREA|93492928|Hc Robotic Asst Stent Des Ld/lad Artery Or Branch|92928,92928|24101,24102|,|,|WS HB DEFAULT|20,822.00
WS SERVICE AREA|90010014|Hc Hemodialysis|90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935,90935|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,26803,26805,26806,26807,26808,26809,26810,26812,26813,26814,26815,26816,26817,26818,27401,27402,30201,39101,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|6,255.00
WS SERVICE AREA|90010098|Hc Genetic Counseling Ea 30 Min|G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463,G0463|20201,20202,20501,20502,21201,21202,21203,21204,21401,22301,22302,23201,23202,23203,23501,24101,24102,24201,24202,24203,24205,24301,24302,24303,24701,25401,25402,26001,26901,26902,26903,26904,26905,26906,27401,27402,27501,27901,31601,34801,34901,35701,38501|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|377.00
WS SERVICE AREA|90010141|Hc Er Level B 1|99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281,99281|24101,24102,20101,20102,20103,20105,20601,20107,20201,20202,20705,24502,30001,31701,22202,22203,22205,22206,22207,30101,20701,20109,20108,37901,38001,24501,23107,23101,23102,23104,35502,35501,26401,36601,37501,37301,37201,32401,22701,37101,32201,37001,23602,23603,36901,25701,25703,25702,25901,26102,26501,27101,31101,36801,36701,27701,38501,38801,21109,21130,21118,21110,21125,21104,21103,21131,21105,21132,21112,21113,21133,21106,21120,21121,21117,21124,21123,21116,21122,21107,21108,21135,21126,21115,21134,21111,21119,21114,21128,21129,35401,21201,21202,21203,21204,20501,20502,25401,27401,27402,30201,30401,30501,30502,30503,30504,30505,30506,30507,30508,30510,30601,46801,46802,48101,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|349.00
WS SERVICE AREA|80081421|Hc Antidepressants,not Otherwise Specified|G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482|20201,20202,20501,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27401,27402,27501,27901,30301,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|248.00
WS SERVICE AREA|90010142|Hc Er Level B Ii|99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282,99282|24101,24102,20101,20102,20103,20105,20601,20107,20201,20202,20705,24502,30001,31701,22202,22203,22205,22206,22207,30101,20701,20109,20108,37901,38001,24501,23107,23101,23102,23104,35502,35501,26401,36601,37501,37301,37201,32401,22701,37101,32201,37001,23602,23603,36901,25701,25703,25702,25901,26102,26501,27101,31101,36801,36701,27701,38501,38801,21109,21130,21118,21110,21125,21104,21103,21131,21105,21132,21112,21113,21133,21106,21120,21121,21117,21124,21123,21116,21122,21107,21108,21135,21126,21115,21134,21111,21119,21114,21128,21129,35401,21201,21202,21203,21204,20501,20502,25401,27401,27402,30201,30401,30501,30502,30503,30504,30505,30506,30507,30508,30510,30601,46801,46802,48101,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|507.00
WS SERVICE AREA|90010143|Hc Er Level B Iii|99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283,99283|24101,24102,20101,20102,20103,20105,20601,20107,20201,20202,20705,24502,30001,31701,22202,22203,22205,22206,22207,30101,20701,20109,20108,37901,38001,24501,23107,23101,23102,23104,35502,35501,26401,36601,37501,37301,37201,32401,22701,37101,32201,37001,23602,23603,36901,25701,25703,25702,25901,26102,26501,27101,31101,36801,36701,27701,38501,38801,21109,21130,21118,21110,21125,21104,21103,21131,21105,21132,21112,21113,21133,21106,21120,21121,21117,21124,21123,21116,21122,21107,21108,21135,21126,21115,21134,21111,21119,21114,21128,21129,35401,21201,21202,21203,21204,20501,20502,25401,27401,27402,30201,30401,30501,30502,30503,30504,30505,30506,30507,30508,30510,30601,46801,46802,48101,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|1,014.00
WS SERVICE AREA|80081422|Hc Antidepressants,serotonergic Class; 1 Or 2|G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480,G0480|20201,20202,20501,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27401,27402,27501,27901,30301,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|248.00
WS SERVICE AREA|90010144|Hc Er Level B Iv|99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284,99284|24101,24102,20101,20102,20103,20105,20601,20107,20201,20202,20705,24502,30001,31701,22202,22203,22205,22206,22207,30101,20701,20109,20108,37901,38001,24501,23107,23101,23102,23104,35502,35501,26401,36601,37501,37301,37201,32401,22701,37101,32201,37001,23602,23603,36901,25701,25703,25702,25901,26102,26501,27101,31101,36801,36701,27701,38501,38801,21109,21130,21118,21110,21125,21104,21103,21131,21105,21132,21112,21113,21133,21106,21120,21121,21117,21124,21123,21116,21122,21107,21108,21135,21126,21115,21134,21111,21119,21114,21128,21129,35401,21201,21202,21203,21204,20501,20502,25401,27401,27402,30201,30401,30501,30502,30503,30504,30505,30506,30507,30508,30510,30601,46801,46802,48101,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|1,419.00
WS SERVICE AREA|90010145|Hc Er Level B V|99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285,99285|24101,24102,20101,20102,20103,20105,20601,20107,20201,20202,20705,24502,30001,31701,22202,22203,22205,22206,22207,30101,20701,20109,20108,37901,38001,24501,23107,23101,23102,23104,35502,35501,26401,36601,37501,37301,37201,32401,22701,37101,32201,37001,23602,23603,36901,25701,25703,25702,25901,26102,26501,27101,31101,36801,36701,27701,38501,38801,21109,21130,21118,21110,21125,21104,21103,21131,21105,21132,21112,21113,21133,21106,21120,21121,21117,21124,21123,21116,21122,21107,21108,21135,21126,21115,21134,21111,21119,21114,21128,21129,35401,21201,21202,21203,21204,20501,20502,25401,27401,27402,30201,30401,30501,30502,30503,30504,30505,30506,30507,30508,30510,30601,46801,46802,48101,51101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|1,955.00
WS SERVICE AREA|80081423|Hc Antidepressants, Serotonergic Class; 6 Or More|G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482,G0482|20201,20202,20501,20502,21201,21202,21203,21204,21501,21601,22301,23201,23202,23203,23501,24102,24201,24202,24203,24204,24205,24301,24302,24303,24701,25401,25402,26001,26201,26202,26203,26204,26205,26206,26901,26902,26903,26904,26905,27001,27401,27402,27501,27901,30301,31601,33201,33402,34801,34901|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|260.00
WS SERVICE AREA|93592928|Hc Robotic Asst Stent Des Lc/lcx Artery Or Branch|92928,92928|24101,24102|,|,|WS HB DEFAULT|20,822.00
WS SERVICE AREA|90010262|HC GENETIC COUNSELING LEVEL IV|99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214,99214|24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|0.00
WS SERVICE AREA|91010016|Hc Therapy Crisis Intervention 60 Mins|90791,90791,90791,90791,90791,90791,90791,90791|20501,24101,24102,25401,25402,27401,46801,46802|,,,,,,,|,,,,,,,|WS HB DEFAULT|800.00
WS SERVICE AREA|93010173|HC 2D TTE W OR W/O FOL W/CON COMPLETE|93306,93306|24101,24102|,|,|WS HB DEFAULT|3,175.00
WS SERVICE AREA|93010174|Hc Echo 2d Tte W Or W/o Fol W/con F/u|93308,93308|24101,24102|,|,|WS HB DEFAULT|1,365.00
WS SERVICE AREA|93010200|HC TTE W OR WO FOL WCON,DOPPLER COMPLETE|93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306,93306|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,25401,25402,27401,27402|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|4,590.00
WS SERVICE AREA|93010203|Hc Tte W Or W/o Contr Cont Ecg|93351,93351|24101,24102|,|,|WS HB DEFAULT|2,652.00
WS SERVICE AREA|97010185|HC ELEC STIM OTHER THAN WOUND 1 OR MORE AREAS|97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|284.00
WS SERVICE AREA|97010186|HC ELEC STIM OTHER THAN WOUND 1 OR MORE AREAS|97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014,97014|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|284.00
WS SERVICE AREA|96010044|Hc Influenza Admin|90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,25401,25402,27401,27402|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|133.00
WS SERVICE AREA|96010045|HC PNEUMOCOCCAL ADMIN|90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471,90471|20501,20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,46801,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|133.00
WS SERVICE AREA|93692928|Hc Robotic Asst Stent Des Rc/rca Artery Or Branch|92928,92928|24101,24102|,|,|WS HB DEFAULT|20,822.00
WS SERVICE AREA|20000260|HC INJ FOR SACROILIAC JT ANESTH|27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096,27096|20502,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27402,35701,46802|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|2,521.00
WS SERVICE AREA|90000463|Hc Hosp Op Visit For Assessment And Management|99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213,99213|20501,20502,21501,24101,24102,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|499.00
WS SERVICE AREA|80080002|Hc Covid-19 N-cdc|87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635,87635|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|290.00
WS SERVICE AREA|90002061|Hc Qual Nonmd Est Pt 5-10m|G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061,G2061|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|45.00
WS SERVICE AREA|90002062|Hc Qual Nonmd Est Pt 11-20m|G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062,G2062|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|80.00
WS SERVICE AREA|90002063|Hc Qual Nonmd Est Pt 21>min|G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063,G2063|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|123.00
WS SERVICE AREA|80085060|Hc Hba1/hba2 Gene Analysis, For Common Deletions Or Variant|81257ZB739,81257ZB739|24201,24203|,|,|WS HB DEFAULT|1,154.00
WS SERVICE AREA|80086408|HC NEUTRALIZING ANTIBODY SARS-COV-2 SCREEN|87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|368.00
WS SERVICE AREA|80086409|HC NEUTRALIZING ANTIBODY SARS-COV-2 TITER|87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|368.00
WS SERVICE AREA|80000225|HC INFECTIOUS DS DNA&RNA 21 TARGETS SARS-COV-2 AMP PROBE|87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|368.00
WS SERVICE AREA|93792928|Hc Robotic Asst Stent Des Lm Artery|92928,92928|24101,24102|,|,|WS HB DEFAULT|20,822.00
WS SERVICE AREA|80000226|HC SURROGATE VIRAL NEUTRALIZATION TEST SARSCOV2 ELISA PLASMA SERUM|87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426,87426|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|368.00
WS SERVICE AREA|80000223|Hc Infectious Disease Bacterial/viral Respiratory Dna/rna 22 Trgt Sarscov2|87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633,87633|20501,20502,21501,24101,24102,24103,24104,24105,24106,24107,24108,24109,24110,24111,24112,24113,24114,24115,24116,24117,24118,24119,24120,24121,24122,24123,24124,24125,24126,24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25401,25402,27401,27402,30201,46801,46802,48101|||WS HB DEFAULT|473.00
WS SERVICE AREA|99301001|Hc Hbot Full Body Chamber Ea 30 Min Interval|99183,99183|24101,24102|,|,|WS HB DEFAULT|1,290.00
WS SERVICE AREA|93010286|HC STENT DES LC/LCX ARTERY OR BRANCH|92928,92928|24101,24102||,|WS HB DEFAULT|18,929.00
WS SERVICE AREA|93010285|HC STENT DES LD/LAD ARTERY OR BRANCH|92928,92928|24101,24102||,|WS HB DEFAULT|18,929.00
WS SERVICE AREA|93010288|HC STENT DES LM ARTERY|92928,92928|24101,24102||,|WS HB DEFAULT|18,929.00
WS SERVICE AREA|93010287|HC STENT DES RC/RCA ARTERY OR BRANCH|92928,92928|24101,24102||,|WS HB DEFAULT|18,929.00
WS SERVICE AREA|93010289|HC STENT DES RAMUS ARTERY|92928,92928|24101,24102||,|WS HB DEFAULT|18,929.00
WS SERVICE AREA|93010294|Hc Stent Des Lc/lcx Additional Branch|92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|5,546.00
WS SERVICE AREA|93010293|Hc Stent Des Ld/lad  Additional Branch|92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929|24127,24128,24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|5,546.00
WS SERVICE AREA|93892928|Hc Robotic Asst Stent Des Ramus Artery|92928,92928|24101,24102|,|,|WS HB DEFAULT|20,822.00
WS SERVICE AREA|93010295|Hc Stent Des Rc/rca Additional Branch|92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929,92929|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|5,546.00
WS SERVICE AREA|93010301|Hc Atherectomy And Des Stent Ld/lad|92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|21,458.00
WS SERVICE AREA|93010302|Hc Atherectomy Des Stent Lc/lcx|92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|21,458.00
WS SERVICE AREA|93010303|Hc Atherectomy And Des Stent Rc/rca|92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|21,458.00
WS SERVICE AREA|93010304|Hc Atherectomy And Des Stent Lm Artery|92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|21,458.00
WS SERVICE AREA|93010305|Hc Atherectomy And Des Stent Ramus Artery|92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933,92933|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|21,458.00
WS SERVICE AREA|93010310|Hc Atherectomy Des Stent Additional Lc/lcx|92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|15,920.00
WS SERVICE AREA|93010309|Hc Atherectomy Des Stent Additional Ld/lad|92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|15,920.00
WS SERVICE AREA|93010311|Hc Atherectomy Des Stent Additional Rc/rca|92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934,92934|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|15,920.00
WS SERVICE AREA|93010316|Hc Graft Ptca And Des Stent To Lc/lcx|92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|22,289.00
WS SERVICE AREA|93092929|Hc Robotic Asst Stent Des Ld/lad Additional Branch|92929,92929|24101,24102|,|,|WS HB DEFAULT|6,101.00
WS SERVICE AREA|93010315|Hc Graft Ptca And Des Stent To Ld/lad|92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|22,289.00
WS SERVICE AREA|93010317|Hc Graft Ptca And Des Stent To Rc/rca|92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937,92937|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|22,289.00
WS SERVICE AREA|93010322|Hc Graft Ptca And/or Des Stent Addtl Lc/lcx|92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|16,750.00
WS SERVICE AREA|93010321|Hc Graft Ptca And/or Des Stent Addtl Ld/lad|92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|16,750.00
WS SERVICE AREA|93010323|Hc Graft Ptca And/or Des Stent Addtl Rc/rca|92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938,92938|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|16,750.00
WS SERVICE AREA|93010327|Hc Ip Only-prq Card Des Revasc Mi 1vsl Lc|92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010325|Hc Ip Only-prq Card Des Revasc Mi 1vsl Ld|92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010331|Hc Ip Only- Prq Card Des Revasc Mi 1vsl Lm|92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010329|Hc Ip Only-prq Card Des Revasc Mi 1vsl Rc|92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93010333|Hc Ip Only-prq Card Des Revasc Mi 1vsl Ri|92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941,92941|24129,24130,24131,24132,24133,24134,24135,24136,24137,24138,24139,24140,24141,24142,24143,24144,24145,24146,25402,27401,30201,46801,48101|,,,,,,,,,,,,,,,,,,,,,,|,,,,,,,,,,,,,,,,,,,,,,|WS HB DEFAULT|31,320.00
WS SERVICE AREA|93192929|Hc Robotic  Asst Stent Des Lc/lcx Additional Branch|92929,92929|24101,24102|,|,|WS HB DEFAULT|6,101.00