|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$6,168.86 |
$6,168.86 |
$6,168.86 |
$2,224.00
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$1,447.84 |
$1,447.84 |
$1,447.84 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$11.14 |
$11.14 |
$11.14 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$5.03 |
$5.03 |
$5.03 |
$22.62
|
|
Opps service,sched team conf
|
$191.70 |
$191.70 |
$191.70 |
$503.90
|
|
Oral everolimus
|
$6.02 |
$6.02 |
$6.02 |
$33.34
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$32.80 |
$32.80 |
$32.80 |
$50.63
|
|
Ortho dvc repair per 15 min
|
$15.00 |
$15.00 |
$15.00 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$100.20 |
$100.20 |
$100.20 |
$279.81
|
|
Ortho ewhf rigd without jnt cstm w
|
$445.20 |
$445.20 |
$445.20 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$275.70 |
$275.70 |
$275.70 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$94.20 |
$94.20 |
$94.20 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$111.60 |
$111.60 |
$111.60 |
$310.00
|
|
Ortho hnd without jnt w/fit&adj
|
$94.20 |
$94.20 |
$94.20 |
$231.00
|
|
Orthovisc inj per dose
|
$488.71 |
$488.71 |
$488.71 |
$537.58
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$116.10 |
$116.10 |
$116.10 |
$420.76
|
|
Oscillation chest wall mechanical per session
|
$100.80 |
$100.80 |
$100.80 |
$195.00
|
|
Osmolality blood
|
$20.10 |
$20.10 |
$20.10 |
$67.60
|
|
Osmolality urine
|
$20.70 |
$20.70 |
$20.70 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$54.60 |
$54.60 |
$54.60 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$54.60 |
$54.60 |
$54.60 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$54.60 |
$54.60 |
$54.60 |
$263.50
|
|
Oth resp proc, group
|
$33.30 |
$33.30 |
$33.30 |
$123.05
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$20.40 |
$20.40 |
$20.40 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$105.00
|
|
Ot re-evaluation patient/family
|
$23.40 |
$23.40 |
$23.40 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$41.06 |
$41.06 |
$41.06 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$201.83 |
$201.83 |
$201.83 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$14.03 |
$14.03 |
$14.03 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$149.90 |
$149.90 |
$149.90 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,675.68 |
$1,675.68 |
$1,675.68 |
$3,435.42
|
|
Palifermin injection
|
$3,196.07 |
$3,196.07 |
$3,196.07 |
$5,464.63
|
|
Paliperidone 117 mg/0.75 ml inj
|
$3,649.10 |
$3,649.10 |
$3,649.10 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$1,608.46 |
$1,608.46 |
$1,608.46 |
$5,569.20
|
|
Palonosetron hcl
|
$174.24 |
$174.24 |
$174.24 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$78.80 |
$78.80 |
$78.80 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$7,408.92 |
$7,408.92 |
$7,408.92 |
$13,051.61
|
|
Parathormone (pth) intact
|
$124.80 |
$124.80 |
$124.80 |
$204.87
|
|
Parathyroid planar imaging
|
$183.90 |
$183.90 |
$183.90 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$183.90 |
$183.90 |
$183.90 |
$1,350.60
|
|
Paricalcitol
|
$12.74 |
$12.74 |
$12.74 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$227.70 |
$227.70 |
$227.70 |
$245.00
|
|
Pcv21 vaccine im
|
$293.43 |
$293.43 |
$293.43 |
$410.26
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$6,561.76 |
$6,561.76 |
$6,561.76 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$4,012.92 |
$4,012.92 |
$4,012.92 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,268.52 |
$4,268.52 |
$4,268.52 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,134.26 |
$2,134.26 |
$2,134.26 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$2,556.00 |
$2,556.00 |
$2,556.00 |
$4,067.80
|
|
Pelv band/spread bar thigh c
|
$163.80 |
$163.80 |
$163.80 |
$802.87
|
|
Pelvic CT scan (with and without contrast)
|
$593.70 |
$593.70 |
$593.70 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$396.00 |
$396.00 |
$396.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$396.00 |
$396.00 |
$396.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$723.30 |
$723.30 |
$723.30 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$533.10 |
$533.10 |
$533.10 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$506.10 |
$506.10 |
$506.10 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$109.20 |
$109.20 |
$109.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$69.60 |
$69.60 |
$69.60 |
$430.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$5,911.60 |
$5,911.60 |
$5,911.60 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$1,405.80 |
$1,405.80 |
$1,405.80 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$248.57 |
$248.57 |
$248.57 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$773.15 |
$773.15 |
$773.15 |
$826.47
|
|
Penile vascular study
|
$65.70 |
$65.70 |
$65.70 |
$574.60
|
|
Pentobarbital sodium inj
|
$121.97 |
$121.97 |
$121.97 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$3,017.39 |
$3,017.39 |
$3,017.39 |
$5,181.67
|
|
Perc d-e cor revasc chro add
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$12,886.61
|
|
Perc d-e cor revasc chro sin
|
$5,548.80 |
$5,548.80 |
$5,548.80 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$12,191.74
|
|
Perc d-e cor stent ather s
|
$5,548.80 |
$5,548.80 |
$5,548.80 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$2,595.60 |
$2,595.60 |
$2,595.60 |
$16,258.50
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$113.69 |
$113.69 |
$113.69 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$635.40 |
$635.40 |
$635.40 |
$2,251.20
|
|
Peritoneogram rs&i
|
$251.10 |
$251.10 |
$251.10 |
$695.89
|
|
Perit-vens shunt pat tst
|
$208.80 |
$208.80 |
$208.80 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$7,559.55
|
|
Perq dev breast 1st mr guide
|
$961.20 |
$961.20 |
$961.20 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$760.20 |
$760.20 |
$760.20 |
$1,456.00
|
|
Perq plmt bile duct stent
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$6,904.15
|
|
Pertuzumab 30 mg/ml desensitization
|
$6,973.27 |
$6,973.27 |
$6,973.27 |
$13,666.00
|
|
Pertuzu, trastuzu, 10 mg
|
$14,228.26 |
$14,228.26 |
$14,228.26 |
$27,833.07
|
|
Pet CT skull-mid thgh initial
|
$1,609.20 |
$1,609.20 |
$1,609.20 |
$4,707.00
|
|
Pet CT whole body initial
|
$1,609.20 |
$1,609.20 |
$1,609.20 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$1,609.20 |
$1,609.20 |
$1,609.20 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$1,609.20 |
$1,609.20 |
$1,609.20 |
$4,305.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$9,405.00 |
$9,405.00 |
$9,405.00 |
$38,834.22
|
|
Ph body fluid
|
$44.40 |
$44.40 |
$44.40 |
$41.28
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$98.67 |
$98.67 |
$98.67 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$34.50 |
$34.50 |
$34.50 |
$104.50
|
|
Phentolaine mesylate inj
|
$455.80 |
$455.80 |
$455.80 |
$1,028.40
|
|
Phenytoin total therapeutic drug level
|
$40.20 |
$40.20 |
$40.20 |
$110.88
|