|
Perphenazine 4mg oral
|
$4.55 |
$4.55 |
$4.55 |
$2.58
|
|
Perq clsr tcat l atr apndge
|
$15,042.38 |
$15,042.38 |
$15,042.38 |
$9,309.08
|
|
Perq dev breast 1st mr guide
|
$2,316.61 |
$2,316.61 |
$2,316.61 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$1,059.07 |
$1,059.07 |
$1,059.07 |
$1,456.00
|
|
Pertuzumab 30 mg/ml desensitization
|
$9,953.06 |
$9,953.06 |
$9,953.06 |
$14,272.91
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$394.35 |
$394.35 |
$394.35 |
$141.60
|
|
Pet CT skull-mid thgh initial
|
$2,813.33 |
$2,813.33 |
$2,813.33 |
$4,707.00
|
|
Pet CT whole body initial
|
$2,813.33 |
$2,813.33 |
$2,813.33 |
$4,850.00
|
|
Ph body fluid
|
$46.37 |
$46.37 |
$46.37 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$80.86 |
$80.86 |
$80.86 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$38.98 |
$38.98 |
$38.98 |
$105.00
|
|
Phentolaine mesylate inj
|
$885.82 |
$885.82 |
$885.82 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$32.18 |
$32.18 |
$32.18 |
$62.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$24.81 |
$24.81 |
$24.81 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$39.20 |
$39.20 |
$39.20 |
$111.27
|
|
Phlebotomy therapeutic
|
$140.28 |
$140.28 |
$140.28 |
$231.40
|
|
Phosphorus
|
$28.06 |
$28.06 |
$28.06 |
$49.20
|
|
Phosphorus 24 hour urine
|
$39.59 |
$39.59 |
$39.59 |
$42.25
|
|
Phys blood bank serv reactj
|
$402.98 |
$402.98 |
$402.98 |
$207.50
|
|
Physical Therapy Evaluation (high complexity)
|
$192.92 |
$192.92 |
$192.92 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$192.92 |
$192.92 |
$192.92 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$192.92 |
$192.92 |
$192.92 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$117.77 |
$117.77 |
$117.77 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$66.15 |
$66.15 |
$66.15 |
$90.25
|
|
Pillow shldr abduc inflat univ
|
$1,148.62 |
$1,148.62 |
$1,148.62 |
$537.66
|
|
Pinworm exam
|
$38.81 |
$38.81 |
$38.81 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$46.33 |
$46.33 |
$46.33 |
$81.36
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$714.90 |
$714.90 |
$714.90 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,024.58 |
$1,024.58 |
$1,024.58 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$730.41 |
$730.41 |
$730.41 |
$1,332.43
|
|
Plasma cryoprecipitate reduced each unit
|
$278.60 |
$278.60 |
$278.60 |
$163.04
|
|
Plas shoe insert w ank joint
|
$209.83 |
$209.83 |
$209.83 |
$245.71
|
|
Plastic mod low ext pad/line
|
$206.25 |
$206.25 |
$206.25 |
$241.54
|
|
Plastic mold recipro hip & c
|
$3,382.06 |
$3,382.06 |
$3,382.06 |
$3,850.61
|
|
Plast socket jts/thgh lacer
|
$5,901.17 |
$5,901.17 |
$5,901.17 |
$5,208.00
|
|
Platelet aggregation each agent teg
|
$176.90 |
$176.90 |
$176.90 |
$148.98
|
|
Platelet automated
|
$51.35 |
$51.35 |
$51.35 |
$46.00
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$2,700.21 |
$2,700.21 |
$2,700.21 |
$1,532.70
|
|
Platelets leukoreduced cmv negative apheresis/phresis each unit
|
$2,815.68 |
$2,815.68 |
$2,815.68 |
$1,094.60
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,700.21 |
$2,700.21 |
$2,700.21 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,851.24 |
$2,851.24 |
$2,851.24 |
$1,284.80
|
|
Platelets pheresis pathogen-reduced each unit
|
$2,935.02 |
$2,935.02 |
$2,935.02 |
$1,005.65
|
|
Plating chrome/nickel pr bar
|
$123.70 |
$123.70 |
$123.70 |
$184.93
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$1,611.96 |
$1,611.96 |
$1,611.96 |
$1,230.00
|
|
Plc pq device breast ea addl lesion MRI guide
|
$1,737.51 |
$1,737.51 |
$1,737.51 |
$1,421.06
|
|
Plc pq device breast ea addl lesion stereo guide
|
$794.25 |
$794.25 |
$794.25 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$310.46 |
$310.46 |
$310.46 |
$754.00
|
|
Pm device progr eval dual
|
$436.41 |
$436.41 |
$436.41 |
$149.15
|
|
Pneum full leg splnt pre ots
|
$372.40 |
$372.40 |
$372.40 |
$309.50
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$99.01 |
$99.01 |
$99.01 |
$187.32
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$27,405.39 |
$27,405.39 |
$27,405.39 |
$35,781.91
|
|
Polycentric hinge pair
|
$359.63 |
$359.63 |
$359.63 |
$282.80
|
|
Polysom <6 yrs cpap/bilvl
|
$3,790.47 |
$3,790.47 |
$3,790.47 |
$3,514.50
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$3,404.80 |
$3,404.80 |
$3,404.80 |
$3,790.61
|
|
Positioner proc acufex leg acs
|
$44.80 |
$44.80 |
$44.80 |
$79.80
|
|
Postop applicat rigid dsg on
|
$816.31 |
$816.31 |
$816.31 |
$616.00
|
|
Postop app non-wgt bear dsg
|
$749.84 |
$749.84 |
$749.84 |
$903.50
|
|
Postop app non-wgt bear dsg
|
$983.47 |
$983.47 |
$983.47 |
$1,389.71
|
|
Postop dress & 1 cast chg bk
|
$2,529.63 |
$2,529.63 |
$2,529.63 |
$2,533.77
|
|
Postop dsg & 1 cast chg ak/d
|
$3,194.80 |
$3,194.80 |
$3,194.80 |
$3,339.01
|
|
Postop dsg ak ea add cast ch
|
$867.22 |
$867.22 |
$867.22 |
$635.60
|
|
Postop dsg bk ea add cast ch
|
$698.82 |
$698.82 |
$698.82 |
$698.82
|
|
Postop dsg cast chg elb dis/
|
$2,673.16 |
$2,673.16 |
$2,673.16 |
$1,831.20
|
|
Postop dsg cast chg wrst/elb
|
$2,245.43 |
$2,245.43 |
$2,245.43 |
$1,456.00
|
|
Postop ea cast chg & realign
|
$741.27 |
$741.27 |
$741.27 |
$602.00
|
|
Post-operative body jacket
|
$2,840.66 |
$2,840.66 |
$2,840.66 |
$3,773.28
|
|
Post-op hip abduct custom fa
|
$1,760.02 |
$1,760.02 |
$1,760.02 |
$1,760.02
|
|
Potassium 24 hour urine
|
$38.70 |
$38.70 |
$38.70 |
$51.17
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$49.44 |
$49.44 |
$49.44 |
$62.79
|
|
Potassium serum/plasma/whole blood
|
$23.13 |
$23.13 |
$23.13 |
$47.85
|
|
Pq dr cath chg w cont s&i
|
$343.56 |
$343.56 |
$343.56 |
$720.00
|
|
Pralidoxime 1 gram solution for injection
|
$182.74 |
$182.74 |
$182.74 |
$292.00
|
|
Pr application of long arm splint
|
$159.49 |
$159.49 |
$159.49 |
$332.75
|
|
Pr application splint static short arm
|
$159.49 |
$159.49 |
$159.49 |
$288.00
|
|
Pr biopsy skin punch single lesion
|
$353.19 |
$353.19 |
$353.19 |
$458.25
|
|
Prealbumin
|
$34.83 |
$34.83 |
$34.83 |
$94.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$98.20 |
$98.20 |
$98.20 |
$13.87
|
|
Prednisone 1 mg tablet
|
$2.31 |
$2.31 |
$2.31 |
$2.88
|
|
Pregnancy associated plasma protein-a
|
$39.98 |
$39.98 |
$39.98 |
$70.85
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$614.21 |
$614.21 |
$614.21 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$425.21 |
$425.21 |
$425.21 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$635.26 |
$635.26 |
$635.26 |
$459.00
|
|
Prep ak ischial direct form
|
$3,592.34 |
$3,592.34 |
$3,592.34 |
$2,898.00
|
|
Prep ak ischial laminated
|
$4,648.56 |
$4,648.56 |
$4,648.56 |
$3,603.60
|
|
Prep ak ischial plast molded
|
$3,701.43 |
$3,701.43 |
$3,701.43 |
$2,643.20
|
|
Prep ak ischial thermo mold
|
$4,458.61 |
$4,458.61 |
$4,458.61 |
$3,516.80
|
|
Prep bk ptb laminated socket
|
$3,248.39 |
$3,248.39 |
$3,248.39 |
$2,713.20
|
|
Prep bk ptb open end socket
|
$3,067.06 |
$3,067.06 |
$3,067.06 |
$4,073.94
|
|
Prep bk ptb plaster molded
|
$2,792.10 |
$2,792.10 |
$2,792.10 |
$1,979.60
|
|
Prep bk ptb thermopls molded
|
$3,290.06 |
$3,290.06 |
$3,290.06 |
$3,998.60
|
|
Pre-tibial shell molded to p
|
$661.30 |
$661.30 |
$661.30 |
$661.30
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$304.81 |
$304.81 |
$304.81 |
$161.40
|
|
Pretreat rbc absorption reference
|
$286.66 |
$286.66 |
$286.66 |
$150.00
|
|
Pretreat rbc density gradient separation reference
|
$341.10 |
$341.10 |
$341.10 |
$182.31
|
|
Pretreat rbc w chem/drugs reference
|
$430.14 |
$430.14 |
$430.14 |
$114.00
|
|
Pretreat rbc w enzyme reference
|
$232.23 |
$232.23 |
$232.23 |
$168.50
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$23.02 |
$23.02 |
$23.02 |
$188.86
|
|
Pr incision & drainage abscess simple/single
|
$464.02 |
$464.02 |
$464.02 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$528.75 |
$528.75 |
$528.75 |
$543.84
|
|
Pr management transitional care high w/in 7 days of discharge
|
$23.02 |
$23.02 |
$23.02 |
$251.56
|