|
Dilation of cervical canal 57800
|
$110.40 |
$172.80 |
$172.80 |
|
|
Dilation of rectal stricture 45910
|
$476.80 |
$476.80 |
$1,032.00 |
|
|
Dilation of salivary duct
|
$162.12 |
$296.80 |
$1,136.97 |
|
|
Dilation of urethra
|
$172.00 |
$172.00 |
$172.00 |
|
|
Dilation of urethra
|
$97.60 |
$97.60 |
$97.60 |
|
|
Dilation of vagina
|
$328.80 |
$328.80 |
$328.80 |
|
|
Dilation salivary duct 42650
|
$156.60 |
$193.60 |
$1,654.21 |
|
|
Dilation/urethral strict/male/ini 53620
|
$220.20 |
$366.40 |
$4,795.88 |
|
|
Dilator fascial 10fx20cm
|
$49.16 |
$274.98 |
$476.28 |
|
|
Dilat xst trc ndurlgc px
|
$766.40 |
$3,625.32 |
$6,894.60 |
|
|
Dilat xst trc new access rcs
|
$1,286.40 |
$5,407.67 |
$7,634.25 |
|
|
Diltiazem 5 mg/ml intravenous solution
|
$1.84 |
$8.85 |
$61.23 |
|
|
Dimecaprol injection
|
$158.35 |
$158.35 |
$158.35 |
|
|
Dimenhydrinate injection
|
$11.65 |
$22.36 |
$22.36 |
|
|
Dimethyl sulfoxide 50% 50 ml
|
$98.40 |
$746.40 |
$3,466.25 |
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.35 |
$0.60 |
$3.45 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$3.70 |
$41.79 |
$11,489.75 |
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$20.32 |
$62.40 |
$62.40 |
|
|
Dipyridamole injection
|
$86.50 |
$86.50 |
$86.50 |
|
|
Direct advanced life support
|
$229.80 |
$236.00 |
$241.20 |
|
|
Dir nsl mucous membrane test
|
$76.80 |
$76.80 |
$76.80 |
|
|
Disability dlco
|
$94.40 |
$279.73 |
$706.88 |
|
|
Disaccharidases
|
$64.28 |
$64.28 |
$648.00 |
|
|
Disarticulation sho sec clsr
|
$2,300.80 |
$2,300.80 |
$2,300.80 |
|
|
Discectomy ant dcmprn cord thoracic 1 ntrspc 63077
|
$2,679.60 |
$3,636.00 |
$3,636.00 |
|
|
Discectomy ant dcmprn cord thoracic ea ntrsp 63078
|
$352.80 |
$370.20 |
$370.20 |
|
|
Discography cerv/thor spine
|
$375.20 |
$375.20 |
$3,834.20 |
|
|
Dise eval slp do brth flx dx
|
$288.80 |
$288.80 |
$10,817.20 |
|
|
Dis site tele svcs rhc/fqhc
|
$90.00 |
$94.80 |
$139.75 |
|
|
Dissolve clot heart vessel
|
$212.10 |
$813.60 |
$2,742.29 |
|
|
Dist revas ligation hemo
|
$2,173.80 |
$5,588.80 |
$5,588.80 |
|
|
Diverticulectomy/hypophar/esoph 43130
|
$1,469.40 |
$1,943.20 |
$1,943.20 |
|
|
Division of fallopian tube 58605
|
$610.80 |
$832.00 |
$832.00 |
|
|
#d/lmeth-l-methamphetamine
|
$72.14 |
$72.14 |
$213.60 |
|
|
Dlyd plmt xtn prosth ea addl
|
$669.48 |
$730.40 |
$9,203.59 |
|
|
Dmd dup/delet analysis
|
$267.84 |
$267.84 |
$267.84 |
|
|
Dmpk gene detc abnor allele
|
$153.56 |
$153.56 |
$153.56 |
|
|
Dna antibody native/double stranded
|
$44.94 |
$101.40 |
$211.90 |
|
|
Dna gardnerella
|
$40.32 |
$50.40 |
$74.40 |
|
|
Dna probe chlamydia
|
$57.00 |
$57.60 |
$122.40 |
|
|
Dna probe gc
|
$56.16 |
$58.40 |
$119.20 |
|
|
Dna trichomonas
|
$49.80 |
$50.40 |
$127.26 |
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$9.60 |
$81.12 |
$183.75 |
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4.00 |
$528.48 |
$2,567.60 |
|
|
Dolasetron mesylate
|
$116.27 |
$116.27 |
$116.27 |
|
|
Dolasetron mesylate oral
|
$114.21 |
$114.21 |
$114.21 |
|
|
Domicil/r-home visit est pat
|
$111.60 |
$117.00 |
$117.00 |
|
|
Domicil/r-home visit est pat
|
$174.60 |
$183.60 |
$183.60 |
|
|
Domicil/r-home visit est pat
|
$247.20 |
$259.80 |
$259.80 |
|
|
Domicil/r-home visit est pat
|
$354.60 |
$372.60 |
$372.60 |
|
|
Domicil/r-home visit new pat
|
$105.00 |
$110.40 |
$110.40 |
|
|
Domicil/r-home visit new pat
|
$151.20 |
$159.00 |
$159.00 |
|
|
Domicil/r-home visit new pat
|
$258.60 |
$271.80 |
$271.80 |
|
|
Domicil/r-home visit new pat
|
$343.20 |
$360.60 |
$360.60 |
|
|
Domicil/r-home visit new pat
|
$399.00 |
$418.80 |
$418.80 |
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$5.35 |
$65.00 |
$119.91 |
|
|
Doppler echo complete
|
$116.80 |
$523.90 |
$2,790.00 |
|
|
Doppler intravascular pressure flow initial vessel
|
$666.40 |
$1,455.35 |
$46,828.53 |
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$308.80 |
$588.25 |
$2,453.00 |
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$189.00 |
$429.12 |
$2,013.00 |
|
|
Doripenem 50 mg/ml inj 10 ml
|
$97.51 |
$97.51 |
$97.51 |
|
|
Dornase alfa non-comp unit
|
$45.38 |
$49.53 |
$50.04 |
|
|
Dornhoffer fixed part w/window
|
$11,529.06 |
$20,628.52 |
$74,450.39 |
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$370.72 |
$36,812.65 |
$36,812.65 |
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$6.40 |
$457.16 |
$1,578.20 |
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$272.90 |
$4,785.36 |
$7,093.75 |
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1.01 |
$28.30 |
$28,588.54 |
|
|
Dpyd gene common variants
|
$350.40 |
$350.40 |
$524.00 |
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$277.92 |
$513.60 |
$925.00 |
|
|
Drainage ext aud canal abscess 69020
|
$276.78 |
$1,124.80 |
$1,268.80 |
|
|
Drainage external ear complex 69005
|
$398.40 |
$1,064.00 |
$3,326.91 |
|
|
Drainage external ear simple 69000
|
$252.48 |
$916.80 |
$1,038.70 |
|
|
Drainage lymph node lesion 38300
|
$635.40 |
$796.80 |
$1,494.36 |
|
|
Drainage lymph node lesion 38305
|
$730.80 |
$1,189.60 |
$1,189.60 |
|
|
Drainage mouth roof lesion
|
$217.92 |
$423.12 |
$792.20 |
|
|
Drainage of abdomen
|
$4,616.80 |
$4,616.80 |
$4,616.80 |
|
|
Drainage of arm bursa 23931
|
$411.36 |
$1,473.40 |
$3,096.25 |
|
|
Drainage of bladder abscess
|
$1,028.80 |
$1,028.80 |
$1,465.80 |
|
|
Drainage of bone lesion
|
$3,153.60 |
$3,153.60 |
$3,153.60 |
|
|
Drainage of eye
|
$595.20 |
$595.20 |
$5,027.33 |
|
|
Drainage of eye
|
$2,302.40 |
$2,302.40 |
$4,573.79 |
|
|
Drainage of eye
|
$3,172.80 |
$3,172.80 |
$3,172.80 |
|
|
Drainage of forearm bursa
|
$1,726.40 |
$1,726.40 |
$1,726.40 |
|
|
Drainage of kidney lesion
|
$492.80 |
$1,286.74 |
$4,093.05 |
|
|
Drainage of mouth lesion
|
$535.20 |
$535.20 |
$535.20 |
|
|
Drainage of mouth lesion
|
$852.80 |
$852.80 |
$852.80 |
|
|
Drainage of mouth lesion
|
$836.80 |
$836.80 |
$836.80 |
|
|
Drainage of mouth lesion
|
$947.00 |
$1,981.14 |
$6,945.73 |
|
|
Drainage of mouth lesion
|
$1,022.40 |
$1,022.40 |
$1,022.40 |
|
|
Drainage of mouth lesion
|
$1,008.80 |
$1,008.80 |
$1,008.80 |
|
|
Drainage of mouth lesion
|
$1,124.80 |
$1,124.80 |
$10,431.16 |
|
|
Drainage of mouth lesion
|
$1,122.40 |
$1,122.40 |
$5,568.35 |
|
|
Drainage of mouth lesion
|
$1,265.60 |
$1,265.60 |
$1,265.60 |
|
|
Drainage of nose lesion int 30000
|
$156.24 |
$615.20 |
$770.52 |
|
|
Drainage of nose lesion sept 30020
|
$323.40 |
$621.60 |
$988.23 |
|
|
Drainage of pelvis bursa
|
$1,741.60 |
$1,741.60 |
$1,741.60 |
|
|
Drainage of pelvis lesion 26990
|
$1,120.80 |
$1,605.60 |
$2,348.00 |
|
|
Drainage of prostate abscess
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
|
|
Drainage of prostate abscess
|
$1,140.80 |
$1,140.80 |
$1,140.80 |
|
|
Drainage of prostate abscess
|
$1,496.80 |
$1,496.80 |
$1,496.80 |
|