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CHOLECYSTOSTOMY","O","$13,389.00 ","$3,917.48 ","$3,917.48 ","$1,449.10 ","$6,694.50 ","$534.59 ","$498.14 ","$1,449.10 ","$7,443.21 ","$1,449.10 ","$3,917.48 ","$10,041.75 ","$4,309.23 ","$8,435.07 ","$9,773.97 ","$1,738.92 ","$1,449.10 ","$10,711.20 ","$8,033.40 ","$13,319.44 ","$22,329.64 ","$1,449.10 ","$3,917.48 ","$4,700.98 ","$2,028.74 ","$10,711.20 ","$1,449.10 ","$1,449.10 ","$1,738.92 ","$5,484.47 ","$1,449.10 ","$3,917.48 ","$3,917.48 ","$4,270.05 ","$10,711.20 ","$11,380.65 ","$1,449.10 ","$3,564.00 ","$1,738.92 ","$1,449.10 ","$1,449.10 ","$10,538.02 ","$5,484.47 ","$5,484.47 ","$2,742.24 ","$5,484.47 ","$6,267.97 ","$4,113.36 ","$3,917.48 ","$11,164.82 ","$1,449.10 ","$1,449.10 ","$3,329.86 ","$3,329.86 ","$3,917.48 ","$498.14 ","$22,329.64 "],["330104","47531","","","","","","","5341","279","320","HC INJECTION FOR CHOLANGIOGRAM","O","$13,389.00 ","$3,917.48 ","$3,917.48 ","$355.06 ","$6,694.50 ","$110.33 ","$102.81 ","$355.06 ","$7,443.21 ","$355.06 ","$3,917.48 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C-","O","$315.00 ","$134.05 ","$134.05 ","$34.83 ","$157.50 ","$153.19 ","$142.75 ","$34.83 ","$254.70 ","$34.83 ","$134.05 ","$236.25 ","$147.46 ","$198.45 ","$229.95 ","$41.80 ","$34.83 ","$252.00 ","$189.00 ","$455.78 ","$764.10 ","$34.83 ","$134.05 ","$160.86 ","$48.76 ","$252.00 ","$34.83 ","$34.83 ","$41.80 ","$187.67 ","$34.83 ","$134.05 ","$134.05 ","$146.12 ","$252.00 ","$267.75 ","$34.83 ","$236.25 ","$41.80 ","$34.83 ","$34.83 ","$360.60 ","$187.67 ","$187.67 ","$93.84 ","$187.67 ","$214.48 ","$140.76 ","$134.05 ","$382.05 ","$34.83 ","$34.83 ","$113.94 ","$113.94 ","$134.05 ","$34.83 ","$764.10 "],["330104","71275","","","","","","","5571","302","350","HC CT ANGIOGRAPHY CHEST","O","$4,400.00 ","$219.94 ","$219.94 ","$140.00 ","$2,200.00 ","$349.08 ","$325.28 ","$140.00 ","$417.89 ","$140.00 ","$219.94 ","$3,300.00 ","$241.94 ","$2,772.00 ","$3,969.95 ","$168.00 ","$140.00 ","$3,520.00 ","$2,640.00 ","$747.80 ","$1,253.67 ","$140.00 ","$219.94 ","$263.93 ","$196.00 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FURTHER SEQ","O","$3,255.00 ","$453.42 ","$453.42 ","$500.00 ","$883.00 ","$0.00 ","$0.00 ","$181.00 ","$238.00 ","$181.00 ","$125.00 ","$2,441.25 ","$498.76 ","$1,901.00 ","$4,741.11 ","$600.00 ","$500.00 ","$2,946.00 ","$1,953.00 ","$1,627.78 ","$2,689.00 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$0.00 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$2,604.00 ","$2,766.75 ","$500.00 ","$1,792.00 ","$600.00 ","$500.00 ","$500.00 ","$0.00 ","$1,132.60 ","$1,955.44 ","$1,544.46 ","$1,302.49 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$0.00 ","$385.41 ","$453.42 ","$0.00 ","$4,741.11 "],["330104","92953","","","","","","","5781","93","450","HC TEMPORARY EXTERNAL PACING","O","$2,310.00 ","$691.70 ","$691.70 ","$572.82 ","$883.00 ","$0.00 ","$0.00 ","$181.00 ","$238.00 ","$181.00 ","$125.00 ","$1,732.50 ","$760.87 ","$1,901.00 ","$1,582.35 ","$687.38 ","$572.82 ","$2,946.00 ","$1,386.00 ","$2,483.20 ","$2,689.00 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HOUR","O","$5,851.00 ","$917.16 ","$917.16 ","$197.38 ","$883.00 ","$0.00 ","$0.00 ","$181.00 ","$238.00 ","$181.00 ","$125.00 ","$4,388.25 ","$1,008.88 ","$1,901.00 ","$3,523.00 ","$236.86 ","$197.38 ","$2,946.00 ","$3,510.60 ","$3,292.62 ","$2,689.00 ","$197.38 ","$917.16 ","$1,100.60 ","$276.33 ","$0.00 ","$197.38 ","$197.38 ","$236.86 ","$1,284.03 ","$197.38 ","$917.16 ","$917.16 ","$999.71 ","$4,680.80 ","$4,973.35 ","$197.38 ","$1,792.00 ","$236.86 ","$197.38 ","$197.38 ","$0.00 ","$1,132.60 ","$1,955.44 ","$1,544.46 ","$1,302.49 ","$0.00 ","$963.02 ","$917.16 ","$0.00 ","$197.38 ","$197.38 ","$0.00 ","$779.59 ","$917.16 ","$0.00 ","$4,973.35 "],["330104","99292","","","","","","","","491","450","HC CRITICAL CARE ADDL 30 MIN","O","$5,323.00 ","$0.00 ","$0.00 ","$0.00 ","$883.00 ","$2,661.50 ","$2,661.50 ","$181.00 ","$238.00 ","$181.00 ","$125.00 ","$3,992.25 ","$0.00 ","$1,901.00 ","$3,523.00 ","$1,863.05 ","$1,863.05 ","$2,946.00 ","$3,193.80 ","$0.00 ","$2,689.00 ","$1,863.05 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","$2,219.20 ","$1,664.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$2,219.20 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,219.20 ","$2,357.90 ","$500.00 ","$2,080.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$3,336.80 "],["330104","75561","","","","","","","5572","295","610","HC CARDIAC MRI FOR MORPH W\/DYE","O","$3,255.00 ","$453.42 ","$453.42 ","$500.00 ","$1,627.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$2,441.25 ","$498.76 ","$2,050.65 ","$4,741.11 ","$600.00 ","$500.00 ","$2,604.00 ","$1,953.00 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$2,604.00 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$2,604.00 ","$2,766.75 ","$500.00 ","$2,441.25 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$4,741.11 "],["330104","73223","","","","","","","5572","295","610","HC MRI JOINT UPR EXTR W\/O&W\/DYE","O","$3,522.00 ","$453.42 ","$453.42 ","$500.00 ","$1,761.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$2,641.50 ","$498.76 ","$2,218.86 ","$7,999.29 ","$600.00 ","$500.00 ","$2,817.60 ","$2,113.20 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,274.45 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$2,817.60 ","$2,993.70 ","$500.00 ","$2,641.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,999.29 "],["330104","77046","","","","","","","5523","293","610","HC MRI BREAST C- UNILATERAL","O","$7,253.00 ","$283.32 ","$283.32 ","$500.00 ","$3,626.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$5,439.75 ","$311.65 ","$4,569.39 ","$5,294.69 ","$600.00 ","$500.00 ","$5,802.40 ","$4,351.80 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$5,802.40 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$5,802.40 ","$6,165.05 ","$500.00 ","$5,439.75 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$368.90 ","$297.49 ","$283.32 ","$368.90 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$6,165.05 "],["330104","77047","","","","","","","5523","293","610","HC MRI BREAST C- BILATERAL","O","$7,832.00 ","$283.32 ","$283.32 ","$500.00 ","$3,916.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$5,874.00 ","$311.65 ","$4,934.16 ","$5,717.36 ","$600.00 ","$500.00 ","$6,265.60 ","$4,699.20 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$6,265.60 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$6,265.60 ","$6,657.20 ","$500.00 ","$5,874.00 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$368.90 ","$297.49 ","$283.32 ","$368.90 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$6,657.20 "],["330104","77048","","","","","","","","295","610","HC MRI BREAST C-+ W\/CAD UNI","O","$7,833.00 ","$325.64 ","$325.64 ","$500.00 ","$3,916.50 ","$3,916.50 ","$3,916.50 ","$500.00 ","$618.72 ","$500.00 ","$325.64 ","$5,874.75 ","$358.21 ","$4,934.79 ","$5,718.09 ","$2,741.55 ","$2,741.55 ","$6,266.40 ","$4,699.80 ","$1,107.19 ","$1,856.17 ","$2,741.55 ","$325.64 ","$390.77 ","$700.00 ","$6,266.40 ","$500.00 ","$500.00 ","$600.00 ","$455.90 ","$500.00 ","$325.64 ","$325.64 ","$354.95 ","$6,266.40 ","$6,658.05 ","$500.00 ","$5,874.75 ","$600.00 ","$500.00 ","$500.00 ","$5,091.45 ","$455.90 ","$455.90 ","$227.95 ","$455.90 ","$471.10 ","$341.93 ","$325.64 ","$471.10 ","$3,916.50 ","$500.00 ","$276.80 ","$276.80 ","$325.64 ","$227.95 ","$6,658.05 "],["330104","77049","","","","","","","","295","610","HC MRI BREAST C-+ W\/CAD BI","O","$10,340.00 ","$323.10 ","$323.10 ","$500.00 ","$5,170.00 ","$5,170.00 ","$5,170.00 ","$500.00 ","$613.90 ","$500.00 ","$323.10 ","$7,755.00 ","$355.42 ","$6,514.20 ","$7,548.20 ","$3,619.00 ","$3,619.00 ","$8,272.00 ","$6,204.00 ","$1,098.56 ","$1,841.70 ","$3,619.00 ","$323.10 ","$387.73 ","$700.00 ","$8,272.00 ","$500.00 ","$500.00 ","$600.00 ","$452.35 ","$500.00 ","$323.10 ","$323.10 ","$352.18 ","$8,272.00 ","$8,789.00 ","$500.00 ","$7,755.00 ","$600.00 ","$500.00 ","$500.00 ","$6,721.00 ","$452.35 ","$452.35 ","$226.17 ","$452.35 ","$468.80 ","$339.26 ","$323.10 ","$468.80 ","$5,170.00 ","$500.00 ","$274.64 ","$274.64 ","$323.10 ","$226.17 ","$8,789.00 "],["330104","74712","","","","","","","5523","293","610","HC MRI FETAL SNGL\/1ST GESTATION","O","$2,625.00 ","$283.32 ","$283.32 ","$145.13 ","$1,312.50 ","$1,458.00 ","$1,353.00 ","$145.13 ","$538.31 ","$145.13 ","$283.32 ","$1,968.75 ","$311.65 ","$1,653.75 ","$1,916.25 ","$174.16 ","$145.13 ","$2,100.00 ","$1,575.00 ","$963.29 ","$1,614.93 ","$145.13 ","$283.32 ","$339.98 ","$203.18 ","$2,100.00 ","$145.13 ","$145.13 ","$174.16 ","$396.65 ","$145.13 ","$283.32 ","$283.32 ","$308.82 ","$2,100.00 ","$2,231.25 ","$145.13 ","$1,968.75 ","$174.16 ","$145.13 ","$145.13 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$437.66 ","$297.49 ","$283.32 ","$437.66 ","$145.13 ","$145.13 ","$240.82 ","$240.82 ","$283.32 ","$145.13 ","$2,231.25 "],["330104","73222","","","","","","","5573","295","610","HC MRI JOINT UPR EXTREM W\/DYE","O","$2,996.00 ","$880.91 ","$880.91 ","$500.00 ","$1,498.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$1,673.73 ","$500.00 ","$880.91 ","$2,247.00 ","$969.00 ","$1,887.48 ","$4,328.73 ","$600.00 ","$500.00 ","$2,396.80 ","$1,797.60 ","$2,995.10 ","$5,021.19 ","$500.00 ","$880.91 ","$1,057.09 ","$700.00 ","$688.88 ","$500.00 ","$500.00 ","$600.00 ","$1,233.27 ","$500.00 ","$880.91 ","$880.91 ","$960.19 ","$2,396.80 ","$2,546.60 ","$500.00 ","$2,247.00 ","$600.00 ","$500.00 ","$500.00 ","$2,369.65 ","$1,233.27 ","$1,233.27 ","$616.64 ","$1,233.27 ","$699.17 ","$924.96 ","$880.91 ","$699.17 ","$500.00 ","$500.00 ","$748.77 ","$748.77 ","$880.91 ","$500.00 ","$5,021.19 "],["330104","71551","","","","","","","5573","295","610","HC MRI CHEST W\/DYE","O","$7,029.00 ","$880.91 ","$880.91 ","$500.00 ","$3,514.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$1,673.73 ","$500.00 ","$880.91 ","$5,271.75 ","$969.00 ","$4,428.27 ","$5,108.85 ","$600.00 ","$500.00 ","$5,623.20 ","$4,217.40 ","$2,995.10 ","$5,021.19 ","$500.00 ","$880.91 ","$1,057.09 ","$700.00 ","$691.33 ","$500.00 ","$500.00 ","$600.00 ","$1,233.27 ","$500.00 ","$880.91 ","$880.91 ","$960.19 ","$5,623.20 ","$5,974.65 ","$500.00 ","$5,271.75 ","$600.00 ","$500.00 ","$500.00 ","$2,369.65 ","$1,233.27 ","$1,233.27 ","$616.64 ","$1,233.27 ","$699.17 ","$924.96 ","$880.91 ","$699.17 ","$500.00 ","$500.00 ","$748.77 ","$748.77 ","$880.91 ","$500.00 ","$5,974.65 "],["330104","73220","","","","","","","5572","295","610","HC MRI UPPR EXTREMITY W\/O&W\/DYE","O","$4,261.00 ","$453.42 ","$453.42 ","$500.00 ","$2,130.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,195.75 ","$498.76 ","$2,684.43 ","$7,999.29 ","$600.00 ","$500.00 ","$3,408.80 ","$2,556.60 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,274.45 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,408.80 ","$3,621.85 ","$500.00 ","$3,195.75 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,999.29 "],["330104","74185","","","","","","","","282","610","HC MRA W\/O CONT ABD","O","$7,052.00 ","$344.87 ","$344.87 ","$500.00 ","$3,526.00 ","$3,526.00 ","$3,526.00 ","$500.00 ","$655.25 ","$500.00 ","$344.87 ","$5,289.00 ","$379.35 ","$4,442.76 ","$4,316.22 ","$2,468.20 ","$2,468.20 ","$5,641.60 ","$4,231.20 ","$1,172.55 ","$1,965.74 ","$2,468.20 ","$344.87 ","$413.84 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$482.81 ","$500.00 ","$344.87 ","$344.87 ","$375.90 ","$5,641.60 ","$5,994.20 ","$500.00 ","$5,289.00 ","$600.00 ","$500.00 ","$500.00 ","$4,583.80 ","$482.81 ","$482.81 ","$241.41 ","$482.81 ","$590.37 ","$362.11 ","$344.87 ","$590.37 ","$3,526.00 ","$500.00 ","$293.14 ","$293.14 ","$344.87 ","$241.41 ","$5,994.20 "],["330104","71555","","","","","","","","282","610","HC MRA W\/O CONT CHEST","O","$7,592.00 ","$341.06 ","$341.06 ","$500.00 ","$3,796.00 ","$3,796.00 ","$3,796.00 ","$500.00 ","$648.01 ","$500.00 ","$341.06 ","$5,694.00 ","$375.16 ","$4,782.96 ","$4,349.99 ","$2,657.20 ","$2,657.20 ","$6,073.60 ","$4,555.20 ","$1,159.60 ","$1,944.03 ","$2,657.20 ","$341.06 ","$409.27 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$477.48 ","$500.00 ","$341.06 ","$341.06 ","$371.75 ","$6,073.60 ","$6,453.20 ","$500.00 ","$5,694.00 ","$600.00 ","$500.00 ","$500.00 ","$4,934.80 ","$477.48 ","$477.48 ","$238.74 ","$477.48 ","$590.91 ","$358.11 ","$341.06 ","$590.91 ","$3,796.00 ","$500.00 ","$289.90 ","$289.90 ","$341.06 ","$238.74 ","$6,453.20 "],["330104","73725","","","","","","","","282","610","HC MRA W\/O CONT LWR EXT","O","$7,052.00 ","$341.90 ","$341.90 ","$500.00 ","$3,526.00 ","$3,526.00 ","$3,526.00 ","$500.00 ","$649.62 ","$500.00 ","$341.90 ","$5,289.00 ","$376.09 ","$4,442.76 ","$4,325.47 ","$2,468.20 ","$2,468.20 ","$5,641.60 ","$4,231.20 ","$1,162.47 ","$1,948.85 ","$2,468.20 ","$341.90 ","$410.28 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$478.67 ","$500.00 ","$341.90 ","$341.90 ","$372.68 ","$5,641.60 ","$5,994.20 ","$500.00 ","$5,289.00 ","$600.00 ","$500.00 ","$500.00 ","$4,583.80 ","$478.67 ","$478.67 ","$239.33 ","$478.67 ","$592.54 ","$359.00 ","$341.90 ","$592.54 ","$3,526.00 ","$500.00 ","$290.62 ","$290.62 ","$341.90 ","$239.33 ","$5,994.20 "],["330104","70336","","","","","","","5523","293","610","HC MAGNETIC IMAGE JAW JOINT","O","$2,774.00 ","$283.32 ","$283.32 ","$500.00 ","$1,387.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$2,080.50 ","$311.65 ","$1,747.62 ","$3,691.00 ","$600.00 ","$500.00 ","$2,219.20 ","$1,664.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,219.20 ","$2,357.90 ","$500.00 ","$2,080.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$3,691.00 "],["330104","70540","","","","","","","5523","293","610","HC MRI ORBIT\/FACE\/NECK W\/O DYE","O","$2,522.00 ","$283.32 ","$283.32 ","$500.00 ","$1,261.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$1,891.50 ","$311.65 ","$1,588.86 ","$4,088.68 ","$600.00 ","$500.00 ","$2,017.60 ","$1,513.20 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$574.26 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,017.60 ","$2,143.70 ","$500.00 ","$1,891.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$4,088.68 "],["330104","70542","","","","","","","5572","295","610","HC MRI ORBIT\/FACE\/NECK W\/DYE","O","$6,131.00 ","$453.42 ","$453.42 ","$500.00 ","$3,065.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$4,598.25 ","$498.76 ","$3,862.53 ","$4,492.73 ","$600.00 ","$500.00 ","$4,904.80 ","$3,678.60 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$688.88 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$4,904.80 ","$5,211.35 ","$500.00 ","$4,598.25 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$5,211.35 "],["330104","70544","","","","","","","5523","282","610","HC MR ANGIOGRAPHY HEAD W\/O DYE","O","$4,130.00 ","$283.32 ","$283.32 ","$500.00 ","$2,065.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$3,097.50 ","$311.65 ","$2,601.90 ","$4,534.11 ","$600.00 ","$500.00 ","$3,304.00 ","$2,478.00 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$3,304.00 ","$3,510.50 ","$500.00 ","$3,097.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$4,534.11 "],["330104","73221","","","","","","","5523","293","610","HC MRI JOINT UPR EXTREM W\/O DYE","O","$2,774.00 ","$283.32 ","$283.32 ","$500.00 ","$1,387.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$2,080.50 ","$311.65 ","$1,747.62 ","$3,941.33 ","$600.00 ","$500.00 ","$2,219.20 ","$1,664.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$574.26 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,219.20 ","$2,357.90 ","$500.00 ","$2,080.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$3,941.33 "],["330104","70545","","","","","","","5572","282","610","HC MR ANGIOGRAPHY HEAD W\/DYE","O","$4,062.00 ","$453.42 ","$453.42 ","$500.00 ","$2,031.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,046.50 ","$498.76 ","$2,559.06 ","$4,512.65 ","$600.00 ","$500.00 ","$3,249.60 ","$2,437.20 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,249.60 ","$3,452.70 ","$500.00 ","$3,046.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$4,512.65 "],["330104","70547","","","","","","","5523","282","610","HC MR ANGIOGRAPHY NECK W\/O DYE","O","$4,062.00 ","$283.32 ","$283.32 ","$500.00 ","$2,031.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$3,046.50 ","$311.65 ","$2,559.06 ","$4,521.84 ","$600.00 ","$500.00 ","$3,249.60 ","$2,437.20 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$3,249.60 ","$3,452.70 ","$500.00 ","$3,046.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$4,521.84 "],["330104","70548","","","","","","","5572","282","610","HC MR ANGIOGRAPHY NECK W\/DYE","O","$4,062.00 ","$453.42 ","$453.42 ","$500.00 ","$2,031.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,046.50 ","$498.76 ","$2,559.06 ","$4,718.22 ","$600.00 ","$500.00 ","$3,249.60 ","$2,437.20 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,249.60 ","$3,452.70 ","$500.00 ","$3,046.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$4,718.22 "],["330104","70549","","","","","","","5572","282","610","HC MR ANGIOGRAPH NECK W\/O&W\/DYE","O","$4,062.00 ","$453.42 ","$453.42 ","$500.00 ","$2,031.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,046.50 ","$498.76 ","$2,559.06 ","$7,210.04 ","$600.00 ","$500.00 ","$3,249.60 ","$2,437.20 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,138.81 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,249.60 ","$3,452.70 ","$500.00 ","$3,046.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,210.04 "],["330104","71550","","","","","","","5523","293","610","HC MRI CHEST W\/O DYE","O","$7,029.00 ","$283.32 ","$283.32 ","$500.00 ","$3,514.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$5,271.75 ","$311.65 ","$4,428.27 ","$4,588.10 ","$600.00 ","$500.00 ","$5,623.20 ","$4,217.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$577.32 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$5,623.20 ","$5,974.65 ","$500.00 ","$5,271.75 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$5,974.65 "],["330104","71552","","","","","","","5572","295","610","HC MRI CHEST W\/O & W\/DYE","O","$7,673.00 ","$453.42 ","$453.42 ","$500.00 ","$3,836.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$5,754.75 ","$498.76 ","$4,833.99 ","$7,930.90 ","$600.00 ","$500.00 ","$6,138.40 ","$4,603.80 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,265.86 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$6,138.40 ","$6,522.05 ","$500.00 ","$5,754.75 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,930.90 "],["330104","72196","","","","","","","5572","295","610","HC MRI PELVIS W\/DYE","O","$6,278.00 ","$453.42 ","$453.42 ","$500.00 ","$3,139.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$4,708.50 ","$498.76 ","$3,955.14 ","$4,550.34 ","$600.00 ","$500.00 ","$5,022.40 ","$3,766.80 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$691.33 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$5,022.40 ","$5,336.30 ","$500.00 ","$4,708.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$5,336.30 "],["330104","73218","","","","","","","5523","293","610","HC MRI UPPER EXTREMITY W\/O DYE","O","$2,774.00 ","$283.32 ","$283.32 ","$500.00 ","$1,387.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$2,080.50 ","$311.65 ","$1,747.62 ","$4,199.10 ","$600.00 ","$500.00 ","$2,219.20 ","$1,664.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$574.26 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,219.20 ","$2,357.90 ","$500.00 ","$2,080.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$4,199.10 "],["330104","73219","","","","","","","5572","295","610","HC MRI UPPER EXTREMITY W\/DYE","O","$4,261.00 ","$453.42 ","$453.42 ","$500.00 ","$2,130.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,195.75 ","$498.76 ","$2,684.43 ","$4,551.01 ","$600.00 ","$500.00 ","$3,408.80 ","$2,556.60 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$688.88 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,408.80 ","$3,621.85 ","$500.00 ","$3,195.75 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$4,551.01 "],["330104","70546","","","","","","","5572","282","610","HC MR ANGIOGRAPH HEAD W\/O&W\/DYE","O","$4,062.00 ","$453.42 ","$453.42 ","$500.00 ","$2,031.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$3,046.50 ","$498.76 ","$2,559.06 ","$7,203.87 ","$600.00 ","$500.00 ","$3,249.60 ","$2,437.20 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,138.81 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$3,249.60 ","$3,452.70 ","$500.00 ","$3,046.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,203.87 "],["330104","70543","","","","","","","5572","295","610","HC MRI ORBT\/FAC\/NCK W\/O &W\/DYE","O","$6,131.00 ","$453.42 ","$453.42 ","$500.00 ","$3,065.50 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$4,598.25 ","$498.76 ","$3,862.53 ","$7,999.29 ","$600.00 ","$500.00 ","$4,904.80 ","$3,678.60 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,274.45 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$4,904.80 ","$5,211.35 ","$500.00 ","$4,598.25 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$7,999.29 "],["330104","70555","","","","","","","5523","293","611","HC FMRI BRAIN BY PHYS\/PSYCH","O","$861.00 ","$283.32 ","$283.32 ","$0.00 ","$430.50 ","$1,458.00 ","$1,353.00 ","$0.00 ","$538.31 ","$0.00 ","$283.32 ","$645.75 ","$311.65 ","$542.43 ","$628.53 ","$0.00 ","$0.00 ","$688.80 ","$516.60 ","$963.29 ","$1,614.93 ","$0.00 ","$283.32 ","$339.98 ","$0.00 ","$688.80 ","$0.00 ","$0.00 ","$0.00 ","$396.65 ","$0.00 ","$283.32 ","$283.32 ","$308.82 ","$688.80 ","$731.85 ","$0.00 ","$645.75 ","$0.00 ","$0.00 ","$0.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$0.00 ","$0.00 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","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$5,997.60 "],["330104","72148","","","","","","","5523","293","612","HC MRI LUMBAR SPINE W\/O DYE","O","$2,774.00 ","$283.32 ","$283.32 ","$500.00 ","$1,387.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$2,080.50 ","$311.65 ","$1,747.62 ","$4,095.09 ","$600.00 ","$500.00 ","$2,219.20 ","$1,664.40 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$648.27 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$2,219.20 ","$2,357.90 ","$500.00 ","$2,080.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$4,095.09 "],["330104","72147","","","","","","","5572","295","612","HC MRI CHEST SPINE W\/DYE","O","$7,690.00 ","$453.42 ","$453.42 ","$500.00 ","$3,845.00 ","$1,458.00 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","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$6,152.00 ","$6,536.50 ","$500.00 ","$5,767.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$6,536.50 "],["330104","72149","","","","","","","5572","295","612","HC MRI LUMBAR SPINE W\/DYE","O","$2,996.00 ","$453.42 ","$453.42 ","$500.00 ","$1,498.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$2,247.00 ","$498.76 ","$1,887.48 ","$4,630.85 ","$600.00 ","$500.00 ","$2,396.80 ","$1,797.60 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$700.54 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$2,396.80 ","$2,546.60 ","$500.00 ","$2,247.00 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$699.17 ","$476.09 ","$453.42 ","$699.17 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$4,630.85 "],["330104","72195","","","","","","","5523","293","614","HC MRI PELVIS W\/O DYE","O","$6,278.00 ","$283.32 ","$283.32 ","$500.00 ","$3,139.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$538.31 ","$500.00 ","$283.32 ","$4,708.50 ","$311.65 ","$3,955.14 ","$4,152.31 ","$600.00 ","$500.00 ","$5,022.40 ","$3,766.80 ","$963.29 ","$1,614.93 ","$500.00 ","$283.32 ","$339.98 ","$700.00 ","$577.32 ","$500.00 ","$500.00 ","$600.00 ","$396.65 ","$500.00 ","$283.32 ","$283.32 ","$308.82 ","$5,022.40 ","$5,336.30 ","$500.00 ","$4,708.50 ","$600.00 ","$500.00 ","$500.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$548.69 ","$297.49 ","$283.32 ","$548.69 ","$500.00 ","$500.00 ","$240.82 ","$240.82 ","$283.32 ","$198.32 ","$5,336.30 "],["330104","72197","","","","","","","5572","295","614","HC MRI PELVIS W\/O & W\/DYE","O","$6,278.00 ","$453.42 ","$453.42 ","$500.00 ","$3,139.00 ","$1,458.00 ","$1,353.00 ","$500.00 ","$861.50 ","$500.00 ","$453.42 ","$4,708.50 ","$498.76 ","$3,955.14 ","$8,033.40 ","$600.00 ","$500.00 ","$5,022.40 ","$3,766.80 ","$1,541.63 ","$2,584.50 ","$500.00 ","$453.42 ","$544.11 ","$700.00 ","$1,278.13 ","$500.00 ","$500.00 ","$600.00 ","$634.79 ","$500.00 ","$453.42 ","$453.42 ","$494.23 ","$5,022.40 ","$5,336.30 ","$500.00 ","$4,708.50 ","$600.00 ","$500.00 ","$500.00 ","$1,219.70 ","$634.79 ","$634.79 ","$317.40 ","$634.79 ","$853.76 ","$476.09 ","$453.42 ","$853.76 ","$500.00 ","$500.00 ","$385.41 ","$385.41 ","$453.42 ","$317.40 ","$8,033.40 "],["330104","76391","","","","","","","5523","293","614","HC MR ELASTOGRAPHY","O","$861.00 ","$283.32 ","$283.32 ","$0.00 ","$430.50 ","$1,458.00 ","$1,353.00 ","$0.00 ","$538.31 ","$0.00 ","$283.32 ","$645.75 ","$311.65 ","$542.43 ","$628.53 ","$0.00 ","$0.00 ","$688.80 ","$516.60 ","$963.29 ","$1,614.93 ","$0.00 ","$283.32 ","$339.98 ","$0.00 ","$688.80 ","$0.00 ","$0.00 ","$0.00 ","$396.65 ","$0.00 ","$283.32 ","$283.32 ","$308.82 ","$688.80 ","$731.85 ","$0.00 ","$645.75 ","$0.00 ","$0.00 ","$0.00 ","$762.13 ","$396.65 ","$396.65 ","$198.32 ","$396.65 ","$368.90 ","$297.49 ","$283.32 ","$368.90 ","$0.00 ","$0.00 ","$240.82 ","$240.82 ","$283.32 ","$0.00 ","$1,614.93 "],["330104","74185","","","","","","","","282","618","HC MRA W\/CONT ABD","O","$7,052.00 ","$344.87 ","$344.87 ","$500.00 ","$3,526.00 ","$3,526.00 ","$3,526.00 ","$500.00 ","$655.25 ","$500.00 ","$344.87 ","$5,289.00 ","$379.35 ","$4,442.76 ","$4,316.22 ","$2,468.20 ","$2,468.20 ","$5,641.60 ","$4,231.20 ","$1,172.55 ","$1,965.74 ","$2,468.20 ","$344.87 ","$413.84 ","$700.00 ","$584.69 ","$500.00 ","$500.00 ","$600.00 ","$482.81 ","$500.00 ","$344.87 ","$344.87 ","$375.90 ","$5,641.60 ","$5,994.20 ","$500.00 ","$5,289.00 ","$600.00 ","$500.00 ","$500.00 ","$4,583.80 ","$482.81 ","$482.81 ","$241.41 ","$482.81 ","$590.37 ","$362.11 ","$344.87 ","$590.37 ","$3,526.00 ","$500.00 ","$293.14 ","$293.14 ","$344.87 ","$241.41 ","$5,994.20 "],["330104","72198","","","","","","","","282","618","HC MRA W\/O CONT PELVIS","O","$7,052.00 ","$344.02 ","$344.02 ","$500.00 ","$3,526.00 ","$3,526.00 ","$3,526.00 ","$500.00 ","$653.64 ","$500.00 ","$344.02 ","$5,289.00 ","$378.42 ","$4,442.76 ","$4,328.49 ","$2,468.20 ","$2,468.20 ","$5,641.60 ","$4,231.20 ","$1,169.67 ","$1,960.92 ","$2,468.20 ","$344.02 ","$412.82 ","$700.00 ","$5,641.60 ","$500.00 ","$500.00 ","$600.00 ","$481.63 ","$500.00 ","$344.02 ","$344.02 ","$374.98 ","$5,641.60 ","$5,994.20 ","$500.00 ","$5,289.00 ","$600.00 ","$500.00 ","$500.00 ","$4,583.80 ","$481.63 ","$481.63 ","$240.81 ","$481.63 ","$590.91 ","$361.22 ","$344.02 ","$590.91 ","$3,526.00 ","$500.00 ","$292.42 ","$292.42 ","$344.02 ","$240.81 ","$5,994.20 "],["330104","72159","","","","","","","","282","618","HC MRA W\/DYE SPINAL CANAL","O","$6,737.00 ","$355.45 ","$355.45 ","$500.00 ","$3,368.50 ","$3,368.50 ","$3,368.50 ","$500.00 ","$675.35 ","$500.00 ","$355.45 ","$5,052.75 ","$390.99 ","$4,244.31 ","$4,739.08 ","$2,357.95 ","$2,357.95 ","$5,389.60 ","$4,042.20 ","$1,208.52 ","$2,026.05 ","$2,357.95 ","$355.45 ","$426.54 ","$700.00 ","$5,389.60 ","$500.00 ","$500.00 ","$600.00 ","$497.63 ","$500.00 ","$355.45 ","$355.45 ","$387.44 ","$5,389.60 ","$5,726.45 ","$500.00 ","$5,052.75 ","$600.00 ","$500.00 ","$500.00 ","$4,379.05 ","$497.63 ","$497.63 ","$248.81 ","$497.63 ","$698.56 ","$373.22 ","$355.45 ","$698.56 ","$3,368.50 ","$500.00 ","$302.13 ","$302.13 ","$355.45 ","$248.81 ","$5,726.45 "],["330104","73225","","","","","","","","282","618","HC MRA W\/DYE UPPER EXTREMITY","O","$6,737.00 ","$355.45 ","$355.45 ","$500.00 ","$3,368.50 ","$3,368.50 ","$3,368.50 ","$500.00 ","$675.35 ","$500.00 ","$355.45 ","$5,052.75 ","$390.99 ","$4,244.31 ","$4,629.23 ","$2,357.95 ","$2,357.95 ","$5,389.60 ","$4,042.20 ","$1,208.52 ","$2,026.05 ","$2,357.95 ","$355.45 ","$426.54 ","$700.00 ","$5,389.60 ","$500.00 ","$500.00 ","$600.00 ","$497.63 ","$500.00 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PROCEDURES WITH CC","I","$0.00 ","$0.00 ","$19,540.24 ","$0.00 ","$32,717.45 ","$33,788.69 ","$31,356.12 ","$0.00 ","$37,126.45 ","$0.00 ","$19,540.24 ","$69,082.60 ","$21,494.26 ","$73,091.20 ","$67,195.94 ","$0.00 ","$0.00 ","$142,036.76 ","$0.00 ","$98,508.66 ","$133,592.44 ","$0.00 ","$20,126.45 ","$24,229.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,356.33 ","$0.00 ","$19,540.24 ","$19,540.24 ","$21,298.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$80,217.59 ","$47,035.90 ","$88,571.12 ","$60,635.20 ","$54,091.28 ","$33,395.83 ","$21,494.26 ","$19,540.24 ","$35,657.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,540.24 ","$0.00 ","$142,036.76 "],["330104","","","","","425","","","","","","OTHER HEPATOBILIARY OR PANCREAS O.R. 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PROCEDURES WITH CC","I","$0.00 ","$0.00 ","$6,884.78 ","$0.00 ","$11,148.37 ","$11,513.39 ","$10,684.50 ","$0.00 ","$13,081.09 ","$0.00 ","$6,884.78 ","$23,539.68 ","$7,573.26 ","$24,905.60 ","$22,896.81 ","$0.00 ","$0.00 ","$48,398.59 ","$0.00 ","$33,566.52 ","$45,521.21 ","$0.00 ","$7,091.33 ","$8,537.13 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,638.69 ","$0.00 ","$6,884.78 ","$6,884.78 ","$7,504.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,333.90 ","$16,027.34 ","$30,180.33 ","$20,661.26 ","$18,431.44 ","$11,379.52 ","$7,573.26 ","$6,884.78 ","$12,150.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,884.78 ","$0.00 ","$48,398.59 "],["330104","","","","","833","","","","","","OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$4,856.78 ","$0.00 ","$7,691.99 ","$7,943.84 ","$7,371.94 ","$0.00 ","$9,227.89 ","$0.00 ","$4,856.78 ","$16,241.57 ","$5,342.46 ","$17,184.00 ","$15,798.00 ","$0.00 ","$0.00 ","$33,393.35 ","$0.00 ","$23,159.74 ","$31,408.06 ","$0.00 ","$5,002.49 ","$6,022.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,799.50 ","$0.00 ","$4,856.78 ","$4,856.78 ","$5,293.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,859.44 ","$11,058.31 ","$20,823.38 ","$14,255.55 ","$12,717.05 ","$7,851.48 ","$5,342.46 ","$4,856.78 ","$8,383.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,856.78 ","$0.00 ","$33,393.35 "],["330104","","","","","834","","","","","","ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC","I","$0.00 ","$0.00 ","$51,209.14 ","$0.00 ","$86,691.71 ","$89,530.19 ","$83,084.60 ","$0.00 ","$97,297.36 ","$0.00 ","$51,209.14 ","$183,048.79 ","$56,330.05 ","$193,670.40 ","$178,049.67 ","$0.00 ","$0.00 ","$376,356.06 ","$0.00 ","$261,019.28 ","$353,981.07 ","$0.00 ","$52,745.41 ","$63,499.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$71,692.79 ","$0.00 ","$51,209.14 ","$51,209.14 ","$55,817.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$212,553.26 ","$124,631.44 ","$234,687.67 ","$160,665.64 ","$143,326.14 ","$88,489.22 ","$56,330.05 ","$51,209.14 ","$94,480.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$51,209.14 ","$0.00 ","$376,356.06 "],["330104","","","","","835","","","","","","ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC","I","$0.00 ","$0.00 ","$18,108.12 ","$0.00 ","$30,276.64 ","$31,267.96 ","$29,016.87 ","$0.00 ","$34,405.42 ","$0.00 ","$18,108.12 ","$63,928.86 ","$19,918.93 ","$67,638.40 ","$62,182.94 ","$0.00 ","$0.00 ","$131,440.43 ","$0.00 ","$91,159.65 ","$123,626.09 ","$0.00 ","$18,651.36 ","$22,454.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,351.36 ","$0.00 ","$18,108.12 ","$18,108.12 ","$19,737.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$74,233.14 ","$43,526.90 ","$81,963.47 ","$56,111.65 ","$50,055.92 ","$30,904.41 ","$19,918.93 ","$18,108.12 ","$32,996.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,108.12 ","$0.00 ","$131,440.43 "],["330104","","","","","836","","","","","","ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$10,206.23 ","$0.00 ","$16,809.21 ","$17,359.59 ","$16,109.81 ","$0.00 ","$19,391.84 ","$0.00 ","$10,206.23 ","$35,492.51 ","$11,226.85 ","$37,552.00 ","$34,523.20 ","$0.00 ","$0.00 ","$72,974.10 ","$0.00 ","$50,610.71 ","$68,635.67 ","$0.00 ","$10,512.42 ","$12,655.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,288.72 ","$0.00 ","$10,206.23 ","$10,206.23 ","$11,124.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,213.32 ","$24,165.59 ","$45,505.10 ","$31,152.49 ","$27,790.43 ","$17,157.74 ","$11,226.85 ","$10,206.23 ","$18,319.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,206.23 ","$0.00 ","$72,974.10 "],["330104","","","","","837","","","","","","CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC","I","$0.00 ","$0.00 ","$48,243.20 ","$0.00 ","$81,636.77 ","$84,309.74 ","$78,239.99 ","$0.00 ","$91,662.07 ","$0.00 ","$48,243.20 ","$172,375.33 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PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC","I","$0.00 ","$0.00 ","$62,712.34 ","$0.00 ","$106,296.97 ","$109,777.37 ","$101,874.12 ","$0.00 ","$119,153.44 ","$0.00 ","$62,712.34 ","$224,445.12 ","$68,983.57 ","$237,468.80 ","$218,315.46 ","$0.00 ","$0.00 ","$461,468.67 ","$0.00 ","$320,048.58 ","$434,033.60 ","$0.00 ","$64,593.71 ","$77,763.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$87,797.28 ","$0.00 ","$62,712.34 ","$62,712.34 ","$68,356.45 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$260,622.01 ","$152,816.74 ","$287,762.09 ","$197,000.03 ","$175,739.23 ","$108,500.98 ","$68,983.57 ","$62,712.34 ","$115,847.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$62,712.34 ","$0.00 ","$461,468.67 "],["330104","","","","","958","","","","","","OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC","I","$0.00 ","$0.00 ","$35,690.28 ","$0.00 ","$60,242.45 ","$62,214.92 ","$57,735.85 ","$0.00 ","$67,811.52 ","$0.00 ","$35,690.28 ","$127,201.40 ","$39,259.30 ","$134,582.40 ","$123,727.49 ","$0.00 ","$0.00 ","$261,531.45 ","$0.00 ","$181,383.43 ","$245,982.98 ","$0.00 ","$36,760.98 ","$44,255.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,966.39 ","$0.00 ","$35,690.28 ","$35,690.28 ","$38,902.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$147,704.18 ","$86,606.93 ","$163,085.48 ","$111,647.25 ","$99,597.96 ","$61,491.54 ","$39,259.30 ","$35,690.28 ","$65,655.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$35,690.28 ","$0.00 ","$261,531.45 "],["330104","","","","","959","","","","","","OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$23,339.06 ","$0.00 ","$39,191.90 ","$40,475.13 ","$37,561.18 ","$0.00 ","$44,344.22 ","$0.00 ","$23,339.06 ","$82,753.34 ","$25,672.97 ","$87,555.20 ","$80,493.33 ","$0.00 ","$0.00 ","$170,144.38 ","$0.00 ","$118,002.52 ","$160,029.02 ","$0.00 ","$24,039.23 ","$28,940.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,674.68 ","$0.00 ","$23,339.06 ","$23,339.06 ","$25,439.58 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$96,091.83 ","$56,343.82 ","$106,098.43 ","$72,634.29 ","$64,795.39 ","$40,004.52 ","$25,672.97 ","$23,339.06 ","$42,713.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,339.06 ","$0.00 ","$170,144.38 "],["330104","","","","","963","","","","","","OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC","I","$0.00 ","$0.00 ","$23,286.95 ","$0.00 ","$39,103.09 ","$40,383.41 ","$37,476.07 ","$0.00 ","$44,245.21 ","$0.00 ","$23,286.95 ","$82,565.83 ","$25,615.65 ","$87,356.80 ","$80,310.93 ","$0.00 ","$0.00 ","$169,758.83 ","$0.00 ","$117,735.13 ","$159,666.39 ","$0.00 ","$23,985.56 ","$28,875.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,601.73 ","$0.00 ","$23,286.95 ","$23,286.95 ","$25,382.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$95,874.09 ","$56,216.15 ","$105,858.01 ","$72,469.70 ","$64,648.56 ","$39,913.87 ","$25,615.65 ","$23,286.95 ","$42,616.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,286.95 ","$0.00 ","$169,758.83 "],["330104","","","","","964","","","","","","OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC","I","$0.00 ","$0.00 ","$12,881.37 ","$0.00 ","$21,368.54 ","$22,068.20 ","$20,479.43 ","$0.00 ","$24,474.61 ","$0.00 ","$12,881.37 ","$45,119.49 ","$14,169.51 ","$47,737.60 ","$43,887.26 ","$0.00 ","$0.00 ","$92,767.58 ","$0.00 ","$64,338.35 ","$87,252.40 ","$0.00 ","$13,267.82 ","$15,972.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,033.92 ","$0.00 ","$12,881.37 ","$12,881.37 ","$14,040.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$52,392.02 ","$30,720.26 ","$57,847.90 ","$39,602.29 ","$35,328.30 ","$21,811.61 ","$14,169.51 ","$12,881.37 ","$23,288.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,881.37 ","$0.00 ","$92,767.58 "],["330104","","","","","965","","","","","","OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$8,012.66 ","$0.00 ","$13,070.65 ","$13,498.61 ","$12,526.80 ","$0.00 ","$15,224.06 ","$0.00 ","$8,012.66 ","$27,598.56 ","$8,813.93 ","$29,200.00 ","$26,844.84 ","$0.00 ","$0.00 ","$56,743.81 ","$0.00 ","$39,354.30 ","$53,370.30 ","$0.00 ","$8,253.04 ","$9,935.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,217.73 ","$0.00 ","$8,012.66 ","$8,012.66 ","$8,733.80 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,047.00 ","$18,790.88 ","$35,384.24 ","$24,223.82 ","$21,609.51 ","$13,341.66 ","$8,813.93 ","$8,012.66 ","$14,245.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,012.66 ","$0.00 ","$56,743.81 "],["330104","","","","","969","","","","","","HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC","I","$0.00 ","$0.00 ","$49,525.72 ","$0.00 ","$83,822.62 ","$86,567.16 ","$80,334.88 ","$0.00 ","$94,098.87 ","$0.00 ","$49,525.72 ","$176,990.72 ","$54,478.29 ","$187,260.80 ","$172,157.05 ","$0.00 ","$0.00 ","$363,900.40 ","$0.00 ","$252,380.74 ","$342,265.93 ","$0.00 ","$51,011.49 ","$61,411.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$69,336.01 ","$0.00 ","$49,525.72 ","$49,525.72 ","$53,983.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$205,518.73 ","$120,506.71 ","$226,920.59 ","$155,348.34 ","$138,582.71 ","$85,560.63 ","$54,478.29 ","$49,525.72 ","$91,354.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,525.72 ","$0.00 ","$363,900.40 "],["330104","","","","","970","","","","","","HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC","I","$0.00 ","$0.00 ","$25,462.03 ","$0.00 ","$42,810.14 ","$44,211.84 ","$41,028.87 ","$0.00 ","$48,377.86 ","$0.00 ","$25,462.03 ","$90,393.23 ","$28,008.23 ","$95,638.40 ","$87,924.57 ","$0.00 ","$0.00 ","$185,852.31 ","$0.00 ","$128,896.65 ","$174,803.09 ","$0.00 ","$26,225.89 ","$31,572.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$35,646.84 ","$0.00 ","$25,462.03 ","$25,462.03 ","$27,753.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$104,963.14 ","$61,545.55 ","$115,893.57 ","$79,339.97 ","$70,777.38 ","$43,697.78 ","$28,008.23 ","$25,462.03 ","$46,656.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,462.03 ","$0.00 ","$185,852.31 "],["330104","","","","","974","","","","","","HIV WITH MAJOR RELATED CONDITION WITH MCC","I","$0.00 ","$0.00 ","$22,955.82 ","$0.00 ","$38,538.72 ","$39,800.57 ","$36,935.18 ","$0.00 ","$43,616.05 ","$0.00 ","$22,955.82 ","$81,374.17 ","$25,251.40 ","$86,096.00 ","$79,151.82 ","$0.00 ","$0.00 ","$167,308.74 ","$0.00 ","$116,035.88 ","$157,361.96 ","$0.00 ","$23,644.49 ","$28,465.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,138.14 ","$0.00 ","$22,955.82 ","$22,955.82 ","$25,021.84 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$94,490.36 ","$55,404.79 ","$104,330.19 ","$71,423.76 ","$63,715.51 ","$39,337.80 ","$25,251.40 ","$22,955.82 ","$42,001.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,955.82 ","$0.00 ","$167,308.74 "],["330104","","","","","975","","","","","","HIV WITH MAJOR RELATED CONDITION WITH CC","I","$0.00 ","$0.00 ","$11,118.96 ","$0.00 ","$18,364.80 ","$18,966.11 ","$17,600.67 ","$0.00 ","$21,126.02 ","$0.00 ","$11,118.96 ","$38,777.11 ","$12,230.85 ","$41,027.20 ","$37,718.10 ","$0.00 ","$0.00 ","$79,727.39 ","$0.00 ","$55,294.41 ","$74,987.46 ","$0.00 ","$11,452.52 ","$13,787.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,566.54 ","$0.00 ","$11,118.96 ","$11,118.96 ","$12,119.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,027.35 ","$26,401.96 ","$49,716.31 ","$34,035.46 ","$30,362.26 ","$18,745.58 ","$12,230.85 ","$11,118.96 ","$20,014.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,118.96 ","$0.00 ","$79,727.39 "],["330104","","","","","976","","","","","","HIV WITH MAJOR RELATED CONDITION WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$8,324.47 ","$0.00 ","$13,602.07 ","$14,047.43 ","$13,036.11 ","$0.00 ","$15,816.49 ","$0.00 ","$8,324.47 ","$28,720.65 ","$9,156.92 ","$30,387.20 ","$27,936.28 ","$0.00 ","$0.00 ","$59,050.88 ","$0.00 ","$40,954.35 ","$55,540.20 ","$0.00 ","$8,574.20 ","$10,322.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,654.26 ","$0.00 ","$8,324.47 ","$8,324.47 ","$9,073.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,349.95 ","$19,554.88 ","$36,822.88 ","$25,208.70 ","$22,488.10 ","$13,884.10 ","$9,156.92 ","$8,324.47 ","$14,824.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,324.47 ","$0.00 ","$59,050.88 "],["330104","","","","","977","","","","","","HIV WITH OR WITHOUT OTHER RELATED CONDITION","I","$0.00 ","$0.00 ","$11,473.62 ","$0.00 ","$18,969.27 ","$19,590.37 ","$18,179.99 ","$0.00 ","$21,799.89 ","$0.00 ","$11,473.62 ","$40,053.45 ","$12,620.99 ","$42,377.60 ","$38,959.58 ","$0.00 ","$0.00 ","$82,351.60 ","$0.00 ","$57,114.41 ","$77,455.66 ","$0.00 ","$11,817.83 ","$14,227.29 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,063.07 ","$0.00 ","$11,473.62 ","$11,473.62 ","$12,506.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$46,509.42 ","$27,270.98 ","$51,352.71 ","$35,155.73 ","$31,361.62 ","$19,362.59 ","$12,620.99 ","$11,473.62 ","$20,673.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,473.62 ","$0.00 ","$82,351.60 "],["330104","","","","","981","","","","","","EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC","I","$0.00 ","$0.00 ","$39,126.02 ","$0.00 ","$66,098.10 ","$68,262.30 ","$63,347.86 ","$0.00 ","$74,339.45 ","$0.00 ","$39,126.02 ","$139,565.55 ","$43,038.63 ","$147,664.00 ","$135,753.98 ","$0.00 ","$0.00 ","$286,952.68 ","$0.00 ","$199,014.16 ","$269,892.88 ","$0.00 ","$40,299.80 ","$48,516.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$54,776.43 ","$0.00 ","$39,126.02 ","$39,126.02 ","$42,647.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$162,061.24 ","$95,025.24 ","$178,937.62 ","$122,499.52 ","$109,279.02 ","$67,468.60 ","$43,038.63 ","$39,126.02 ","$72,036.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,126.02 ","$0.00 ","$286,952.68 "],["330104","","","","","982","","","","","","EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC","I","$0.00 ","$0.00 ","$21,662.37 ","$0.00 ","$36,334.26 ","$37,523.92 ","$34,822.44 ","$0.00 ","$41,158.50 ","$0.00 ","$21,662.37 ","$76,719.47 ","$23,828.60 ","$81,171.20 ","$74,624.24 ","$0.00 ","$0.00 ","$157,738.47 ","$0.00 ","$109,398.48 ","$148,360.66 ","$0.00 ","$22,312.24 ","$26,861.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,327.32 ","$0.00 ","$21,662.37 ","$21,662.37 ","$23,611.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$89,085.39 ","$52,235.57 ","$98,362.37 ","$67,338.23 ","$60,070.90 ","$37,087.63 ","$23,828.60 ","$21,662.37 ","$39,598.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,662.37 ","$0.00 ","$157,738.47 "],["330104","","","","","983","","","","","","EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC\/MCC","I","$0.00 ","$0.00 ","$14,230.29 ","$0.00 ","$23,667.55 ","$24,442.47 ","$22,682.77 ","$0.00 ","$27,037.55 ","$0.00 ","$14,230.29 ","$49,973.81 ","$15,653.32 ","$52,873.60 ","$48,609.01 ","$0.00 ","$0.00 ","$102,748.28 ","$0.00 ","$71,260.39 ","$96,639.72 ","$0.00 ","$14,657.20 ","$17,645.56 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,922.41 ","$0.00 ","$14,230.29 ","$14,230.29 ","$15,511.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$58,028.78 ","$34,025.40 ","$64,071.65 ","$43,863.03 ","$39,129.21 ","$24,158.28 ","$15,653.32 ","$14,230.29 ","$25,794.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,230.29 ","$0.00 ","$102,748.28 "],["330104","","","","","987","","","","","","NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC","I","$0.00 ","$0.00 ","$27,875.80 ","$0.00 ","$46,923.99 ","$48,460.39 ","$44,971.56 ","$0.00 ","$52,964.01 ","$0.00 ","$27,875.80 ","$99,079.60 ","$30,663.38 ","$104,828.80 ","$96,373.70 ","$0.00 ","$0.00 ","$203,711.84 ","$0.00 ","$141,283.02 ","$191,600.84 ","$0.00 ","$28,712.07 ","$34,565.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,026.11 ","$0.00 ","$27,875.80 ","$27,875.80 ","$30,384.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$115,049.61 ","$67,459.79 ","$127,030.39 ","$86,964.17 ","$77,578.75 ","$47,896.93 ","$30,663.38 ","$27,875.80 ","$51,140.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,875.80 ","$0.00 ","$203,711.84 "],["330104","","","","","988","","","","","","NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC","I","$0.00 ","$0.00 ","$14,684.97 ","$0.00 ","$24,442.47 ","$25,242.78 ","$23,425.46 ","$0.00 ","$27,901.45 ","$0.00 ","$14,684.97 ","$51,610.07 ","$16,153.47 ","$54,604.80 ","$50,200.58 ","$0.00 ","$0.00 ","$106,112.48 ","$0.00 ","$73,593.62 ","$99,803.92 ","$0.00 ","$15,125.52 ","$18,209.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,558.96 ","$0.00 ","$14,684.97 ","$14,684.97 ","$16,006.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,928.77 ","$35,139.47 ","$66,169.50 ","$45,299.20 ","$40,410.38 ","$24,949.27 ","$16,153.47 ","$14,684.97 ","$26,638.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,684.97 ","$0.00 ","$106,112.48 "],["330104","","","","","989","","","","","","NON-EXTENSIVE O.R. 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complicated skull Fx coma < 1 hr or no coma","I","$0.00 ","$9,736.33 ","$0.00 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$9,249.52 ","$0.00 ","$9,346.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,462.51 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,028.42 ","$0.00 ","$0.00 ","$13,630.87 ","$38,149.96 ","$9,736.33 ","$13,144.05 ","$11,975.69 ","$0.00 ","$10,028.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,736.33 ","$26,239.87 ","$11,683.60 ","$9,736.33 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,736.33 ","$9,736.33 ","$11,196.78 ","$9,736.33 ","$0.00 ","$0.00 ","$38,149.96 "],["330104","","","","","","56","4","","","","Brain contusion\/laceration & complicated skull Fx coma < 1 hr or no coma","I","$0.00 ","$25,491.10 ","$0.00 ","$25,491.10 ","$0.00 ","$0.00 ","$0.00 ","$24,216.55 ","$0.00 ","$24,471.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,628.61 ","$25,491.10 ","$0.00 ","$0.00 ","$0.00 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","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$2,911.67 ","$2,911.67 ","$3,348.42 ","$2,911.67 ","$0.00 ","$0.00 ","$10,613.11 "],["330104","","","","","","57","2","","","","Concussion closed skull Fx nosuncomplicated intracranial injury coma < 1 hr or no coma","I","$0.00 ","$3,859.36 ","$0.00 ","$3,859.36 ","$0.00 ","$0.00 ","$0.00 ","$3,666.39 ","$0.00 ","$3,704.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,939.98 ","$3,859.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,975.14 ","$0.00 ","$0.00 ","$5,403.10 ","$14,436.93 ","$3,859.36 ","$5,210.13 ","$4,747.01 ","$0.00 ","$3,975.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,859.36 ","$9,929.84 ","$4,631.23 ","$3,859.36 ","$3,859.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,859.36 ","$3,859.36 ","$4,438.26 ","$3,859.36 ","$0.00 ","$0.00 ","$14,436.93 "],["330104","","","","","","57","3","","","","Concussion closed skull Fx nosuncomplicated intracranial injury coma < 1 hr or no coma","I","$0.00 ","$6,699.10 ","$0.00 ","$6,699.10 ","$0.00 ","$0.00 ","$0.00 ","$6,364.15 ","$0.00 ","$6,431.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,574.85 ","$6,699.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,900.07 ","$0.00 ","$0.00 ","$9,378.74 ","$25,895.02 ","$6,699.10 ","$9,043.79 ","$8,239.89 ","$0.00 ","$6,900.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,699.10 ","$17,810.81 ","$8,038.92 ","$6,699.10 ","$6,699.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,699.10 ","$6,699.10 ","$7,703.97 ","$6,699.10 ","$0.00 ","$0.00 ","$25,895.02 "],["330104","","","","","","57","4","","","","Concussion closed skull Fx nosuncomplicated intracranial injury coma < 1 hr or no coma","I","$0.00 ","$19,856.68 ","$0.00 ","$19,856.68 ","$0.00 ","$0.00 ","$0.00 ","$18,863.85 ","$0.00 ","$19,062.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,416.56 ","$19,856.68 ","$0.00 ","$0.00 ","$0.00 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"],["330104","","","","","","93","1","","","","Sinus & mastoid procedures","I","$0.00 ","$6,225.92 ","$0.00 ","$6,225.92 ","$0.00 ","$0.00 ","$0.00 ","$5,914.63 ","$0.00 ","$5,976.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,969.18 ","$6,225.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,412.70 ","$0.00 ","$0.00 ","$8,716.29 ","$23,985.78 ","$6,225.92 ","$8,404.99 ","$7,657.88 ","$0.00 ","$6,412.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,225.92 ","$16,497.62 ","$7,471.11 ","$6,225.92 ","$6,225.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,225.92 ","$6,225.92 ","$7,159.81 ","$6,225.92 ","$0.00 ","$0.00 ","$23,985.78 "],["330104","","","","","","93","2","","","","Sinus & mastoid procedures","I","$0.00 ","$8,457.95 ","$0.00 ","$8,457.95 ","$0.00 ","$0.00 ","$0.00 ","$8,035.05 ","$0.00 ","$8,119.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,826.18 ","$8,457.95 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,711.69 ","$0.00 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","$0.00 ","$0.00 ","$16,280.68 ","$0.00 ","$16,452.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,936.07 ","$17,137.56 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,651.68 ","$0.00 ","$0.00 ","$23,992.58 ","$68,013.19 ","$17,137.56 ","$23,135.70 ","$21,079.19 ","$0.00 ","$17,651.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,137.56 ","$46,780.05 ","$20,565.07 ","$17,137.56 ","$17,137.56 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,137.56 ","$17,137.56 ","$19,708.19 ","$17,137.56 ","$0.00 ","$0.00 ","$68,013.19 "],["330104","","","","","","97","1","","","","Tonsil & adenoid procedures","I","$0.00 ","$3,490.23 ","$0.00 ","$3,490.23 ","$0.00 ","$0.00 ","$0.00 ","$3,315.71 ","$0.00 ","$3,350.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,467.49 ","$3,490.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,594.93 ","$0.00 ","$0.00 ","$4,886.32 ","$12,947.51 ","$3,490.23 ","$4,711.80 ","$4,292.98 ","$0.00 ","$3,594.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,490.23 ","$8,905.41 ","$4,188.27 ","$3,490.23 ","$3,490.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,490.23 ","$3,490.23 ","$4,013.76 ","$3,490.23 ","$0.00 ","$0.00 ","$12,947.51 "],["330104","","","","","","97","2","","","","Tonsil & adenoid procedures","I","$0.00 ","$4,858.07 ","$0.00 ","$4,858.07 ","$0.00 ","$0.00 ","$0.00 ","$4,615.17 ","$0.00 ","$4,663.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,218.33 ","$4,858.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,003.82 ","$0.00 ","$0.00 ","$6,801.30 ","$18,466.64 ","$4,858.07 ","$6,558.40 ","$5,975.43 ","$0.00 ","$5,003.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,858.07 ","$12,701.52 ","$5,829.69 ","$4,858.07 ","$4,858.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,858.07 ","$4,858.07 ","$5,586.78 ","$4,858.07 ","$0.00 ","$0.00 ","$18,466.64 "],["330104","","","","","","97","3","","","","Tonsil & adenoid procedures","I","$0.00 ","$10,083.60 ","$0.00 ","$10,083.60 ","$0.00 ","$0.00 ","$0.00 ","$9,579.42 ","$0.00 ","$9,680.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,907.00 ","$10,083.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,386.11 ","$0.00 ","$0.00 ","$14,117.04 ","$39,551.13 ","$10,083.60 ","$13,612.86 ","$12,402.82 ","$0.00 ","$10,386.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,083.60 ","$27,203.61 ","$12,100.32 ","$10,083.60 ","$10,083.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,083.60 ","$10,083.60 ","$11,596.14 ","$10,083.60 ","$0.00 ","$0.00 ","$39,551.13 "],["330104","","","","","","97","4","","","","Tonsil & adenoid procedures","I","$0.00 ","$26,619.05 ","$0.00 ","$26,619.05 ","$0.00 ","$0.00 ","$0.00 ","$25,288.10 ","$0.00 ","$25,554.29 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$34,072.38 ","$26,619.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,417.62 ","$0.00 ","$0.00 ","$37,266.67 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pulmonary disease","I","$0.00 ","$6,990.03 ","$0.00 ","$6,990.03 ","$0.00 ","$0.00 ","$0.00 ","$6,640.53 ","$0.00 ","$6,710.43 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,947.24 ","$6,990.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,199.74 ","$0.00 ","$0.00 ","$9,786.05 ","$27,068.90 ","$6,990.03 ","$9,436.55 ","$8,597.74 ","$0.00 ","$7,199.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,990.03 ","$18,618.22 ","$8,388.04 ","$6,990.03 ","$6,990.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,990.03 ","$6,990.03 ","$8,038.54 ","$6,990.03 ","$0.00 ","$0.00 ","$27,068.90 "],["330104","","","","","","140","4","","","","Chronic obstructive pulmonary disease","I","$0.00 ","$13,339.53 ","$0.00 ","$13,339.53 ","$0.00 ","$0.00 ","$0.00 ","$12,672.55 ","$0.00 ","$12,805.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,074.59 ","$13,339.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,739.71 ","$0.00 ","$0.00 ","$18,675.34 ","$52,688.50 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","$12,664.06 "],["330104","","","","","","141","2","","","","Asthma","I","$0.00 ","$4,372.30 ","$0.00 ","$4,372.30 ","$0.00 ","$0.00 ","$0.00 ","$4,153.69 ","$0.00 ","$4,197.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,596.55 ","$4,372.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,503.47 ","$0.00 ","$0.00 ","$6,121.22 ","$16,506.60 ","$4,372.30 ","$5,902.61 ","$5,377.93 ","$0.00 ","$4,503.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,372.30 ","$11,353.38 ","$5,246.76 ","$4,372.30 ","$4,372.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,372.30 ","$4,372.30 ","$5,028.15 ","$4,372.30 ","$0.00 ","$0.00 ","$16,506.60 "],["330104","","","","","","141","3","","","","Asthma","I","$0.00 ","$6,495.65 ","$0.00 ","$6,495.65 ","$0.00 ","$0.00 ","$0.00 ","$6,170.86 ","$0.00 ","$6,235.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,314.43 ","$6,495.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,690.52 ","$0.00 ","$0.00 ","$9,093.91 ","$25,074.10 ","$6,495.65 ","$8,769.12 ","$7,989.65 ","$0.00 ","$6,690.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,495.65 ","$17,246.18 ","$7,794.78 ","$6,495.65 ","$6,495.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,495.65 ","$6,495.65 ","$7,469.99 ","$6,495.65 ","$0.00 ","$0.00 ","$25,074.10 "],["330104","","","","","","141","4","","","","Asthma","I","$0.00 ","$11,228.77 ","$0.00 ","$11,228.77 ","$0.00 ","$0.00 ","$0.00 ","$10,667.33 ","$0.00 ","$10,779.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,372.83 ","$11,228.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,565.64 ","$0.00 ","$0.00 ","$15,720.28 ","$44,171.81 ","$11,228.77 ","$15,158.84 ","$13,811.39 ","$0.00 ","$11,565.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,228.77 ","$30,381.74 ","$13,474.53 ","$11,228.77 ","$11,228.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,228.77 ","$11,228.77 ","$12,913.09 ","$11,228.77 ","$0.00 ","$0.00 ","$44,171.81 "],["330104","","","","","","142","1","","","","Interstitial & alveolar lung diseases","I","$0.00 ","$4,702.34 ","$0.00 ","$4,702.34 ","$0.00 ","$0.00 ","$0.00 ","$4,467.22 ","$0.00 ","$4,514.24 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,018.99 ","$4,702.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,843.41 ","$0.00 ","$0.00 ","$6,583.27 ","$17,838.25 ","$4,702.34 ","$6,348.15 ","$5,783.87 ","$0.00 ","$4,843.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,702.34 ","$12,269.30 ","$5,642.80 ","$4,702.34 ","$4,702.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,702.34 ","$4,702.34 ","$5,407.69 ","$4,702.34 ","$0.00 ","$0.00 ","$17,838.25 "],["330104","","","","","","142","2","","","","Interstitial & alveolar lung diseases","I","$0.00 ","$5,974.75 ","$0.00 ","$5,974.75 ","$0.00 ","$0.00 ","$0.00 ","$5,676.01 ","$0.00 ","$5,735.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,647.68 ","$5,974.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,153.99 ","$0.00 ","$0.00 ","$8,364.65 ","$22,972.33 ","$5,974.75 ","$8,065.91 ","$7,348.94 ","$0.00 ","$6,153.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,974.75 ","$15,800.57 ","$7,169.70 ","$5,974.75 ","$5,974.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,974.75 ","$5,974.75 ","$6,870.96 ","$5,974.75 ","$0.00 ","$0.00 ","$22,972.33 "],["330104","","","","","","142","3","","","","Interstitial & alveolar lung diseases","I","$0.00 ","$9,100.79 ","$0.00 ","$9,100.79 ","$0.00 ","$0.00 ","$0.00 ","$8,645.75 ","$0.00 ","$8,736.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,649.01 ","$9,100.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,373.81 ","$0.00 ","$0.00 ","$12,741.10 ","$35,585.59 ","$9,100.79 ","$12,286.06 ","$11,193.97 ","$0.00 ","$9,373.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,100.79 ","$24,476.07 ","$10,920.95 ","$9,100.79 ","$9,100.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,100.79 ","$9,100.79 ","$10,465.91 ","$9,100.79 ","$0.00 ","$0.00 ","$35,585.59 "],["330104","","","","","","142","4","","","","Interstitial & alveolar lung diseases","I","$0.00 ","$18,715.49 ","$0.00 ","$18,715.49 ","$0.00 ","$0.00 ","$0.00 ","$17,779.71 ","$0.00 ","$17,966.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,955.82 ","$18,715.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,276.95 ","$0.00 ","$0.00 ","$26,201.68 ","$74,379.98 ","$18,715.49 ","$25,265.91 ","$23,020.05 ","$0.00 ","$19,276.95 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,715.49 ","$51,159.19 ","$22,458.58 ","$18,715.49 ","$18,715.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,715.49 ","$18,715.49 ","$21,522.81 ","$18,715.49 ","$0.00 ","$0.00 ","$74,379.98 "],["330104","","","","","","143","1","","","","Other respiratory diagnoses except signs symptoms & minor diagnoses","I","$0.00 ","$3,801.04 ","$0.00 ","$3,801.04 ","$0.00 ","$0.00 ","$0.00 ","$3,610.99 ","$0.00 ","$3,649.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,865.33 ","$3,801.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,915.07 ","$0.00 ","$0.00 ","$5,321.46 ","$14,201.61 ","$3,801.04 ","$5,131.40 ","$4,675.28 ","$0.00 ","$3,915.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,801.04 ","$9,767.99 ","$4,561.25 ","$3,801.04 ","$3,801.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,801.04 ","$3,801.04 ","$4,371.20 ","$3,801.04 ","$0.00 ","$0.00 ","$14,201.61 "],["330104","","","","","","143","2","","","","Other respiratory diagnoses except signs symptoms & minor diagnoses","I","$0.00 ","$5,311.37 ","$0.00 ","$5,311.37 ","$0.00 ","$0.00 ","$0.00 ","$5,045.80 ","$0.00 ","$5,098.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,798.56 ","$5,311.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,470.71 ","$0.00 ","$0.00 ","$7,435.92 ","$20,295.66 ","$5,311.37 ","$7,170.35 ","$6,532.99 ","$0.00 ","$5,470.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,311.37 ","$13,959.53 ","$6,373.65 ","$5,311.37 ","$5,311.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,311.37 ","$5,311.37 ","$6,108.08 ","$5,311.37 ","$0.00 ","$0.00 ","$20,295.66 "],["330104","","","","","","143","3","","","","Other respiratory diagnoses except signs symptoms & minor diagnoses","I","$0.00 ","$8,782.68 ","$0.00 ","$8,782.68 ","$0.00 ","$0.00 ","$0.00 ","$8,343.55 ","$0.00 ","$8,431.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,241.84 ","$8,782.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,046.16 ","$0.00 ","$0.00 ","$12,295.76 ","$34,302.07 ","$8,782.68 ","$11,856.62 ","$10,802.70 ","$0.00 ","$9,046.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,782.68 ","$23,593.26 ","$10,539.22 ","$8,782.68 ","$8,782.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,782.68 ","$8,782.68 ","$10,100.09 ","$8,782.68 ","$0.00 ","$0.00 ","$34,302.07 "],["330104","","","","","","143","4","","","","Other respiratory diagnoses except signs symptoms & minor diagnoses","I","$0.00 ","$13,918.08 ","$0.00 ","$13,918.08 ","$0.00 ","$0.00 ","$0.00 ","$13,222.17 ","$0.00 ","$13,361.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,815.14 ","$13,918.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,335.62 ","$0.00 ","$0.00 ","$19,485.31 ","$55,022.90 ","$13,918.08 ","$18,789.40 ","$17,119.24 ","$0.00 ","$14,335.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,918.08 ","$37,845.22 ","$16,701.69 ","$13,918.08 ","$13,918.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,918.08 ","$13,918.08 ","$16,005.79 ","$13,918.08 ","$0.00 ","$0.00 ","$55,022.90 "],["330104","","","","","","144","1","","","","Respiratory signs symptoms & minor diagnoses","I","$0.00 ","$3,281.47 ","$0.00 ","$3,281.47 ","$0.00 ","$0.00 ","$0.00 ","$3,117.40 ","$0.00 ","$3,150.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,200.28 ","$3,281.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,379.91 ","$0.00 ","$0.00 ","$4,594.06 ","$12,105.20 ","$3,281.47 ","$4,429.98 ","$4,036.21 ","$0.00 ","$3,379.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,281.47 ","$8,326.06 ","$3,937.76 ","$3,281.47 ","$3,281.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,281.47 ","$3,281.47 ","$3,773.69 ","$3,281.47 ","$0.00 ","$0.00 ","$12,105.20 "],["330104","","","","","","144","2","","","","Respiratory signs symptoms & minor diagnoses","I","$0.00 ","$4,051.55 ","$0.00 ","$4,051.55 ","$0.00 ","$0.00 ","$0.00 ","$3,848.97 ","$0.00 ","$3,889.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,185.98 ","$4,051.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,173.09 ","$0.00 ","$0.00 ","$5,672.17 ","$15,212.39 ","$4,051.55 ","$5,469.59 ","$4,983.40 ","$0.00 ","$4,173.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,051.55 ","$10,463.21 ","$4,861.86 ","$4,051.55 ","$4,051.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,051.55 ","$4,051.55 ","$4,659.28 ","$4,051.55 ","$0.00 ","$0.00 ","$15,212.39 "],["330104","","","","","","144","3","","","","Respiratory signs symptoms & minor diagnoses","I","$0.00 ","$6,008.55 ","$0.00 ","$6,008.55 ","$0.00 ","$0.00 ","$0.00 ","$5,708.12 ","$0.00 ","$5,768.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,690.94 ","$6,008.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,188.81 ","$0.00 ","$0.00 ","$8,411.97 ","$23,108.71 ","$6,008.55 ","$8,111.54 ","$7,390.52 ","$0.00 ","$6,188.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,008.55 ","$15,894.37 ","$7,210.26 ","$6,008.55 ","$6,008.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,008.55 ","$6,008.55 ","$6,909.83 ","$6,008.55 ","$0.00 ","$0.00 ","$23,108.71 "],["330104","","","","","","144","4","","","","Respiratory signs symptoms & minor diagnoses","I","$0.00 ","$11,540.25 ","$0.00 ","$11,540.25 ","$0.00 ","$0.00 ","$0.00 ","$10,963.24 ","$0.00 ","$11,078.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,771.52 ","$11,540.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,886.46 ","$0.00 ","$0.00 ","$16,156.35 ","$45,428.59 ","$11,540.25 ","$15,579.34 ","$14,194.51 ","$0.00 ","$11,886.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,540.25 ","$31,246.17 ","$13,848.30 ","$11,540.25 ","$11,540.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,540.25 ","$11,540.25 ","$13,271.29 ","$11,540.25 ","$0.00 ","$0.00 ","$45,428.59 "],["330104","","","","","","160","1","","","","Major cardiothoracic repair of heart anomaly","I","$0.00 ","$21,131.75 ","$0.00 ","$21,131.75 ","$0.00 ","$0.00 ","$0.00 ","$20,075.16 ","$0.00 ","$20,286.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,048.64 ","$21,131.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,765.70 ","$0.00 ","$0.00 ","$29,584.45 ","$84,129.39 ","$21,131.75 ","$28,527.87 ","$25,992.06 ","$0.00 ","$21,765.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,131.75 ","$57,864.91 ","$25,358.10 ","$21,131.75 ","$21,131.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,131.75 ","$21,131.75 ","$24,301.52 ","$21,131.75 ","$0.00 ","$0.00 ","$84,129.39 "],["330104","","","","","","160","2","","","","Major cardiothoracic repair of heart anomaly","I","$0.00 ","$22,799.15 ","$0.00 ","$22,799.15 ","$0.00 ","$0.00 ","$0.00 ","$21,659.19 ","$0.00 ","$21,887.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$29,182.91 ","$22,799.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,483.12 ","$0.00 ","$0.00 ","$31,918.81 ","$90,857.17 ","$22,799.15 ","$30,778.85 ","$28,042.95 ","$0.00 ","$23,483.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,799.15 ","$62,492.34 ","$27,358.98 ","$22,799.15 ","$22,799.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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","$10,059.08 ","$0.00 ","$10,059.08 ","$0.00 ","$0.00 ","$0.00 ","$9,556.12 ","$0.00 ","$9,656.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,875.62 ","$10,059.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,360.85 ","$0.00 ","$0.00 ","$14,082.71 ","$39,452.20 ","$10,059.08 ","$13,579.75 ","$12,372.66 ","$0.00 ","$10,360.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,059.08 ","$27,135.56 ","$12,070.89 ","$10,059.08 ","$10,059.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,059.08 ","$10,059.08 ","$11,567.94 ","$10,059.08 ","$0.00 ","$0.00 ","$39,452.20 "],["330104","","","","","","175","2","","","","Percutaneous coronary intervention w\/o AMI","I","$0.00 ","$11,375.90 ","$0.00 ","$11,375.90 ","$0.00 ","$0.00 ","$0.00 ","$10,807.10 ","$0.00 ","$10,920.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,561.15 ","$11,375.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,717.17 ","$0.00 ","$0.00 ","$15,926.25 ","$44,765.43 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"],["330104","","","","","","176","4","","","","Cardiac pacemaker & defibrillator device replacement","I","$0.00 ","$23,815.09 ","$0.00 ","$23,815.09 ","$0.00 ","$0.00 ","$0.00 ","$22,624.34 ","$0.00 ","$22,862.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,483.32 ","$23,815.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,529.55 ","$0.00 ","$0.00 ","$33,341.13 ","$94,956.41 ","$23,815.09 ","$32,150.38 ","$29,292.56 ","$0.00 ","$24,529.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,815.09 ","$65,311.83 ","$28,578.11 ","$23,815.09 ","$23,815.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,815.09 ","$23,815.09 ","$27,387.36 ","$23,815.09 ","$0.00 ","$0.00 ","$94,956.41 "],["330104","","","","","","177","1","","","","Cardiac pacemaker & defibrillator revision except device replacement","I","$0.00 ","$9,520.95 ","$0.00 ","$9,520.95 ","$0.00 ","$0.00 ","$0.00 ","$9,044.90 ","$0.00 ","$9,140.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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"],["330104","","","","","","177","4","","","","Cardiac pacemaker & defibrillator revision except device replacement","I","$0.00 ","$42,261.82 ","$0.00 ","$42,261.82 ","$0.00 ","$0.00 ","$0.00 ","$40,148.73 ","$0.00 ","$40,571.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$54,095.13 ","$42,261.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,529.68 ","$0.00 ","$0.00 ","$59,166.55 ","$169,387.20 ","$42,261.82 ","$57,053.46 ","$51,982.04 ","$0.00 ","$43,529.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,261.82 ","$116,505.96 ","$50,714.19 ","$42,261.82 ","$42,261.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,261.82 ","$42,261.82 ","$48,601.09 ","$42,261.82 ","$0.00 ","$0.00 ","$169,387.20 "],["330104","","","","","","180","1","","","","Other circulatory system procedures","I","$0.00 ","$7,829.70 ","$0.00 ","$7,829.70 ","$0.00 ","$0.00 ","$0.00 ","$7,438.21 ","$0.00 ","$7,516.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,022.01 ","$7,829.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,064.59 ","$0.00 ","$0.00 ","$10,961.58 ","$30,456.86 ","$7,829.70 ","$10,570.09 ","$9,630.53 ","$0.00 ","$8,064.59 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,829.70 ","$20,948.49 ","$9,395.64 ","$7,829.70 ","$7,829.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,829.70 ","$7,829.70 ","$9,004.15 ","$7,829.70 ","$0.00 ","$0.00 ","$30,456.86 "],["330104","","","","","","180","2","","","","Other circulatory system procedures","I","$0.00 ","$11,191.00 ","$0.00 ","$11,191.00 ","$0.00 ","$0.00 ","$0.00 ","$10,631.45 ","$0.00 ","$10,743.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,324.48 ","$11,191.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,526.73 ","$0.00 ","$0.00 ","$15,667.40 ","$44,019.39 ","$11,191.00 ","$15,107.85 ","$13,764.93 ","$0.00 ","$11,526.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,191.00 ","$30,276.91 ","$13,429.20 ","$11,191.00 ","$11,191.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,191.00 ","$11,191.00 ","$12,869.65 ","$11,191.00 ","$0.00 ","$0.00 ","$44,019.39 "],["330104","","","","","","180","3","","","","Other circulatory system procedures","I","$0.00 ","$16,315.79 ","$0.00 ","$16,315.79 ","$0.00 ","$0.00 ","$0.00 ","$15,500.00 ","$0.00 ","$15,663.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,884.21 ","$16,315.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,805.26 ","$0.00 ","$0.00 ","$22,842.10 ","$64,697.43 ","$16,315.79 ","$22,026.31 ","$20,068.42 ","$0.00 ","$16,805.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,315.79 ","$44,499.44 ","$19,578.95 ","$16,315.79 ","$16,315.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,315.79 ","$16,315.79 ","$18,763.16 ","$16,315.79 ","$0.00 ","$0.00 ","$64,697.43 "],["330104","","","","","","180","4","","","","Other circulatory system procedures","I","$0.00 ","$32,218.34 ","$0.00 ","$32,218.34 ","$0.00 ","$0.00 ","$0.00 ","$30,607.43 ","$0.00 ","$30,929.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,239.48 ","$32,218.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,184.90 ","$0.00 ","$0.00 ","$45,105.68 ","$128,862.73 ","$32,218.34 ","$43,494.77 ","$39,628.56 ","$0.00 ","$33,184.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,218.34 ","$88,632.89 ","$38,662.01 ","$32,218.34 ","$32,218.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,218.34 ","$32,218.34 ","$37,051.10 ","$32,218.34 ","$0.00 ","$0.00 ","$128,862.73 "],["330104","","","","","","181","1","","","","Lower extremity arterial procedures #","I","$0.00 ","$9,791.34 ","$0.00 ","$9,791.34 ","$0.00 ","$0.00 ","$0.00 ","$9,301.77 ","$0.00 ","$9,399.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,532.91 ","$9,791.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,085.08 ","$0.00 ","$0.00 ","$13,707.87 ","$38,371.90 ","$9,791.34 ","$13,218.31 ","$12,043.35 ","$0.00 ","$10,085.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,791.34 ","$26,392.52 ","$11,749.61 ","$9,791.34 ","$9,791.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,791.34 ","$9,791.34 ","$11,260.04 ","$9,791.34 ","$0.00 ","$0.00 ","$38,371.90 "],["330104","","","","","","181","2","","","","Lower extremity arterial procedures #","I","$0.00 ","$15,376.06 ","$0.00 ","$15,376.06 ","$0.00 ","$0.00 ","$0.00 ","$14,607.25 ","$0.00 ","$14,761.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,681.35 ","$15,376.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,837.34 ","$0.00 ","$0.00 ","$21,526.48 ","$60,905.70 ","$15,376.06 ","$20,757.67 ","$18,912.55 ","$0.00 ","$15,837.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,376.06 ","$41,891.46 ","$18,451.27 ","$15,376.06 ","$15,376.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,376.06 ","$15,376.06 ","$17,682.46 ","$15,376.06 ","$0.00 ","$0.00 ","$60,905.70 "],["330104","","","","","","181","3","","","","Lower extremity arterial procedures #","I","$0.00 ","$27,388.46 ","$0.00 ","$27,388.46 ","$0.00 ","$0.00 ","$0.00 ","$26,019.04 ","$0.00 ","$26,292.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$35,057.23 ","$27,388.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$28,210.12 ","$0.00 ","$0.00 ","$38,343.85 ","$109,374.62 ","$27,388.46 ","$36,974.43 ","$33,687.81 ","$0.00 ","$28,210.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,388.46 ","$75,228.80 ","$32,866.16 ","$27,388.46 ","$27,388.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,388.46 ","$27,388.46 ","$31,496.73 ","$27,388.46 ","$0.00 ","$0.00 ","$109,374.62 "],["330104","","","","","","181","4","","","","Lower extremity arterial procedures #","I","$0.00 ","$44,130.02 ","$0.00 ","$44,130.02 ","$0.00 ","$0.00 ","$0.00 ","$41,923.52 ","$0.00 ","$42,364.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$56,486.43 ","$44,130.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,453.92 ","$0.00 ","$0.00 ","$61,782.03 ","$176,925.21 ","$44,130.02 ","$59,575.53 ","$54,279.92 ","$0.00 ","$45,453.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$44,130.02 ","$121,690.67 ","$52,956.02 ","$44,130.02 ","$44,130.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$44,130.02 ","$44,130.02 ","$50,749.52 ","$44,130.02 ","$0.00 ","$0.00 ","$176,925.21 "],["330104","","","","","","182","1","","","","Other peripheral vascular procedures #","I","$0.00 ","$10,224.76 ","$0.00 ","$10,224.76 ","$0.00 ","$0.00 ","$0.00 ","$9,713.52 ","$0.00 ","$9,815.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,087.69 ","$10,224.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,531.50 ","$0.00 ","$0.00 ","$14,314.66 ","$40,120.70 ","$10,224.76 ","$13,803.42 ","$12,576.45 ","$0.00 ","$10,531.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,224.76 ","$27,595.36 ","$12,269.71 ","$10,224.76 ","$10,224.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,224.76 ","$10,224.76 ","$11,758.47 ","$10,224.76 ","$0.00 ","$0.00 ","$40,120.70 "],["330104","","","","","","182","2","","","","Other peripheral vascular procedures #","I","$0.00 ","$14,317.70 ","$0.00 ","$14,317.70 ","$0.00 ","$0.00 ","$0.00 ","$13,601.81 ","$0.00 ","$13,744.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,326.65 ","$14,317.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,747.23 ","$0.00 ","$0.00 ","$20,044.77 ","$56,635.32 ","$14,317.70 ","$19,328.89 ","$17,610.77 ","$0.00 ","$14,747.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,317.70 ","$38,954.26 ","$17,181.24 ","$14,317.70 ","$14,317.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,317.70 ","$14,317.70 ","$16,465.35 ","$14,317.70 ","$0.00 ","$0.00 ","$56,635.32 "],["330104","","","","","","182","3","","","","Other peripheral vascular procedures #","I","$0.00 ","$21,647.35 ","$0.00 ","$21,647.35 ","$0.00 ","$0.00 ","$0.00 ","$20,564.98 ","$0.00 ","$20,781.45 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,708.60 ","$21,647.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,296.77 ","$0.00 ","$0.00 ","$30,306.28 ","$86,209.76 ","$21,647.35 ","$29,223.92 ","$26,626.24 ","$0.00 ","$22,296.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,647.35 ","$59,295.81 ","$25,976.82 ","$21,647.35 ","$21,647.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,647.35 ","$21,647.35 ","$24,894.45 ","$21,647.35 ","$0.00 ","$0.00 ","$86,209.76 "],["330104","","","","","","182","4","","","","Other peripheral vascular procedures #","I","$0.00 ","$41,846.96 ","$0.00 ","$41,846.96 ","$0.00 ","$0.00 ","$0.00 ","$39,754.61 ","$0.00 ","$40,173.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$53,564.11 ","$41,846.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,102.37 ","$0.00 ","$0.00 ","$58,585.74 ","$167,713.28 ","$41,846.96 ","$56,493.40 ","$51,471.76 ","$0.00 ","$43,102.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,846.96 ","$115,354.62 ","$50,216.35 ","$41,846.96 ","$41,846.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,846.96 ","$41,846.96 ","$48,124.00 ","$41,846.96 ","$0.00 ","$0.00 ","$167,713.28 "],["330104","","","","","","190","1","","","","Acute myocardial infarction","I","$0.00 ","$5,156.96 ","$0.00 ","$5,156.96 ","$0.00 ","$0.00 ","$0.00 ","$4,899.11 ","$0.00 ","$4,950.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,600.91 ","$5,156.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,311.67 ","$0.00 ","$0.00 ","$7,219.74 ","$19,672.62 ","$5,156.96 ","$6,961.89 ","$6,343.06 ","$0.00 ","$5,311.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,156.96 ","$13,530.99 ","$6,188.35 ","$5,156.96 ","$5,156.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,156.96 ","$5,156.96 ","$5,930.50 ","$5,156.96 ","$0.00 ","$0.00 ","$19,672.62 "],["330104","","","","","","190","2","","","","Acute myocardial infarction","I","$0.00 ","$6,632.17 ","$0.00 ","$6,632.17 ","$0.00 ","$0.00 ","$0.00 ","$6,300.56 ","$0.00 ","$6,366.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,489.17 ","$6,632.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,831.13 ","$0.00 ","$0.00 ","$9,285.03 ","$25,624.94 ","$6,632.17 ","$8,953.43 ","$8,157.57 ","$0.00 ","$6,831.13 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,632.17 ","$17,625.05 ","$7,958.60 ","$6,632.17 ","$6,632.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,632.17 ","$6,632.17 ","$7,626.99 ","$6,632.17 ","$0.00 ","$0.00 ","$25,624.94 "],["330104","","","","","","190","3","","","","Acute myocardial infarction","I","$0.00 ","$9,896.05 ","$0.00 ","$9,896.05 ","$0.00 ","$0.00 ","$0.00 ","$9,401.25 ","$0.00 ","$9,500.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,666.94 ","$9,896.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,192.93 ","$0.00 ","$0.00 ","$13,854.47 ","$38,794.39 ","$9,896.05 ","$13,359.67 ","$12,172.14 ","$0.00 ","$10,192.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,896.05 ","$26,683.11 ","$11,875.26 ","$9,896.05 ","$9,896.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,896.05 ","$9,896.05 ","$11,380.46 ","$9,896.05 ","$0.00 ","$0.00 ","$38,794.39 "],["330104","","","","","","190","4","","","","Acute myocardial infarction","I","$0.00 ","$18,924.90 ","$0.00 ","$18,924.90 ","$0.00 ","$0.00 ","$0.00 ","$17,978.66 ","$0.00 ","$18,167.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,223.88 ","$18,924.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,492.65 ","$0.00 ","$0.00 ","$26,494.87 ","$75,224.97 ","$18,924.90 ","$25,548.62 ","$23,277.63 ","$0.00 ","$19,492.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,924.90 ","$51,740.37 ","$22,709.89 ","$18,924.90 ","$18,924.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,924.90 ","$18,924.90 ","$21,763.64 ","$18,924.90 ","$0.00 ","$0.00 ","$75,224.97 "],["330104","","","","","","191","1","","","","Cardiac catheterization for coronary artery disease","I","$0.00 ","$5,033.03 ","$0.00 ","$5,033.03 ","$0.00 ","$0.00 ","$0.00 ","$4,781.38 ","$0.00 ","$4,831.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,442.28 ","$5,033.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,184.02 ","$0.00 ","$0.00 ","$7,046.24 ","$19,172.58 ","$5,033.03 ","$6,794.59 ","$6,190.63 ","$0.00 ","$5,184.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,033.03 ","$13,187.06 ","$6,039.64 ","$5,033.03 ","$5,033.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,033.03 ","$5,033.03 ","$5,787.99 ","$5,033.03 ","$0.00 ","$0.00 ","$19,172.58 "],["330104","","","","","","191","2","","","","Cardiac catheterization for coronary artery disease","I","$0.00 ","$6,088.08 ","$0.00 ","$6,088.08 ","$0.00 ","$0.00 ","$0.00 ","$5,783.67 ","$0.00 ","$5,844.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,792.74 ","$6,088.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,270.72 ","$0.00 ","$0.00 ","$8,523.31 ","$23,429.59 ","$6,088.08 ","$8,218.90 ","$7,488.33 ","$0.00 ","$6,270.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,088.08 ","$16,115.07 ","$7,305.69 ","$6,088.08 ","$6,088.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,088.08 ","$6,088.08 ","$7,001.29 ","$6,088.08 ","$0.00 ","$0.00 ","$23,429.59 "],["330104","","","","","","191","3","","","","Cardiac catheterization for coronary artery disease","I","$0.00 ","$9,736.33 ","$0.00 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$9,249.52 ","$0.00 ","$9,346.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,462.51 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,028.42 ","$0.00 ","$0.00 ","$13,630.87 ","$38,149.96 ","$9,736.33 ","$13,144.05 ","$11,975.69 ","$0.00 ","$10,028.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,736.33 ","$26,239.87 ","$11,683.60 ","$9,736.33 ","$9,736.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,736.33 ","$9,736.33 ","$11,196.78 ","$9,736.33 ","$0.00 ","$0.00 ","$38,149.96 "],["330104","","","","","","191","4","","","","Cardiac catheterization for coronary artery disease","I","$0.00 ","$17,826.78 ","$0.00 ","$17,826.78 ","$0.00 ","$0.00 ","$0.00 ","$16,935.44 ","$0.00 ","$17,113.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,818.28 ","$17,826.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,361.59 ","$0.00 ","$0.00 ","$24,957.50 ","$70,794.15 ","$17,826.78 ","$24,066.16 ","$21,926.94 ","$0.00 ","$18,361.59 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,826.78 ","$48,692.82 ","$21,392.14 ","$17,826.78 ","$17,826.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,826.78 ","$17,826.78 ","$20,500.80 ","$17,826.78 ","$0.00 ","$0.00 ","$70,794.15 "],["330104","","","","","","192","1","","","","Cardiac catheterization for other non-coronary conditions","I","$0.00 ","$5,040.32 ","$0.00 ","$5,040.32 ","$0.00 ","$0.00 ","$0.00 ","$4,788.30 ","$0.00 ","$4,838.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,451.61 ","$5,040.32 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,191.53 ","$0.00 ","$0.00 ","$7,056.45 ","$19,201.99 ","$5,040.32 ","$6,804.43 ","$6,199.59 ","$0.00 ","$5,191.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,040.32 ","$13,207.30 ","$6,048.38 ","$5,040.32 ","$5,040.32 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,040.32 ","$5,040.32 ","$5,796.37 ","$5,040.32 ","$0.00 ","$0.00 ","$19,201.99 "],["330104","","","","","","192","2","","","","Cardiac catheterization for other non-coronary conditions","I","$0.00 ","$7,037.09 ","$0.00 ","$7,037.09 ","$0.00 ","$0.00 ","$0.00 ","$6,685.23 ","$0.00 ","$6,755.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,007.47 ","$7,037.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,248.20 ","$0.00 ","$0.00 ","$9,851.92 ","$27,258.76 ","$7,037.09 ","$9,500.07 ","$8,655.62 ","$0.00 ","$7,248.20 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,037.09 ","$18,748.80 ","$8,444.50 ","$7,037.09 ","$7,037.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,037.09 ","$7,037.09 ","$8,092.65 ","$7,037.09 ","$0.00 ","$0.00 ","$27,258.76 "],["330104","","","","","","192","3","","","","Cardiac catheterization for other non-coronary conditions","I","$0.00 ","$12,342.14 ","$0.00 ","$12,342.14 ","$0.00 ","$0.00 ","$0.00 ","$11,725.03 ","$0.00 ","$11,848.45 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,797.93 ","$12,342.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,712.40 ","$0.00 ","$0.00 ","$17,278.99 ","$48,664.13 ","$12,342.14 ","$16,661.88 ","$15,180.83 ","$0.00 ","$12,712.40 ","$0.00 ","$0.00 ","$0.00 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"],["330104","","","","","","193","1","","","","Acute & subacute endocarditis","I","$0.00 ","$7,119.26 ","$0.00 ","$7,119.26 ","$0.00 ","$0.00 ","$0.00 ","$6,763.30 ","$0.00 ","$6,834.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,112.66 ","$7,119.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,332.84 ","$0.00 ","$0.00 ","$9,966.97 ","$27,590.33 ","$7,119.26 ","$9,611.01 ","$8,756.69 ","$0.00 ","$7,332.84 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,119.26 ","$18,976.87 ","$8,543.12 ","$7,119.26 ","$7,119.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,119.26 ","$7,119.26 ","$8,187.15 ","$7,119.26 ","$0.00 ","$0.00 ","$27,590.33 "],["330104","","","","","","193","2","","","","Acute & subacute endocarditis","I","$0.00 ","$9,414.25 ","$0.00 ","$9,414.25 ","$0.00 ","$0.00 ","$0.00 ","$8,943.54 ","$0.00 ","$9,037.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,050.24 ","$9,414.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,696.68 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or procedure","I","$0.00 ","$19,064.08 ","$0.00 ","$19,064.08 ","$0.00 ","$0.00 ","$0.00 ","$18,110.87 ","$0.00 ","$18,301.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,402.02 ","$19,064.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,636.00 ","$0.00 ","$0.00 ","$26,689.71 ","$75,786.51 ","$19,064.08 ","$25,736.50 ","$23,448.81 ","$0.00 ","$19,636.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,064.08 ","$52,126.61 ","$22,876.89 ","$19,064.08 ","$19,064.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,064.08 ","$19,064.08 ","$21,923.69 ","$19,064.08 ","$0.00 ","$0.00 ","$75,786.51 "],["330104","","","","","","253","1","","","","Other & unspecified gastrointestinal hemorrhage","I","$0.00 ","$4,326.57 ","$0.00 ","$4,326.57 ","$0.00 ","$0.00 ","$0.00 ","$4,110.25 ","$0.00 ","$4,153.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,538.02 ","$4,326.57 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,456.37 ","$0.00 ","$0.00 ","$6,057.20 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procedures","I","$0.00 ","$41,068.93 ","$0.00 ","$41,068.93 ","$0.00 ","$0.00 ","$0.00 ","$39,015.48 ","$0.00 ","$39,426.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$52,568.23 ","$41,068.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,301.00 ","$0.00 ","$0.00 ","$57,496.50 ","$164,574.00 ","$41,068.93 ","$55,443.06 ","$50,514.78 ","$0.00 ","$42,301.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,068.93 ","$113,195.40 ","$49,282.72 ","$41,068.93 ","$41,068.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,068.93 ","$41,068.93 ","$47,229.27 ","$41,068.93 ","$0.00 ","$0.00 ","$164,574.00 "],["330104","","","","","","279","1","","","","Hepatic coma & other major acute liver disorders","I","$0.00 ","$3,923.64 ","$0.00 ","$3,923.64 ","$0.00 ","$0.00 ","$0.00 ","$3,727.46 ","$0.00 ","$3,766.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,022.26 ","$3,923.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,041.35 ","$0.00 ","$0.00 ","$5,493.10 ","$14,696.30 ","$3,923.64 ","$5,296.92 ","$4,826.08 ","$0.00 ","$4,041.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,923.64 ","$10,108.24 ","$4,708.37 ","$3,923.64 ","$3,923.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,923.64 ","$3,923.64 ","$4,512.19 ","$3,923.64 ","$0.00 ","$0.00 ","$14,696.30 "],["330104","","","","","","279","2","","","","Hepatic coma & other major acute liver disorders","I","$0.00 ","$5,465.79 ","$0.00 ","$5,465.79 ","$0.00 ","$0.00 ","$0.00 ","$5,192.50 ","$0.00 ","$5,247.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,996.20 ","$5,465.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,629.76 ","$0.00 ","$0.00 ","$7,652.10 ","$20,918.70 ","$5,465.79 ","$7,378.81 ","$6,722.92 ","$0.00 ","$5,629.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,465.79 ","$14,388.06 ","$6,558.94 ","$5,465.79 ","$5,465.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,465.79 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limb except toes","I","$0.00 ","$12,986.30 ","$0.00 ","$12,986.30 ","$0.00 ","$0.00 ","$0.00 ","$12,336.98 ","$0.00 ","$12,466.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,622.46 ","$12,986.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,375.89 ","$0.00 ","$0.00 ","$18,180.82 ","$51,263.25 ","$12,986.30 ","$17,531.50 ","$15,973.15 ","$0.00 ","$13,375.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,986.30 ","$35,259.30 ","$15,583.56 ","$12,986.30 ","$12,986.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,986.30 ","$12,986.30 ","$14,934.24 ","$12,986.30 ","$0.00 ","$0.00 ","$51,263.25 "],["330104","","","","","","305","3","","","","Amputation of lower limb except toes","I","$0.00 ","$22,693.78 ","$0.00 ","$22,693.78 ","$0.00 ","$0.00 ","$0.00 ","$21,559.09 ","$0.00 ","$21,786.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$29,048.03 ","$22,693.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,374.59 ","$0.00 ","$0.00 ","$31,771.29 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","$42,044.45 ","$42,044.45 ","$48,351.12 ","$42,044.45 ","$0.00 ","$0.00 ","$168,510.13 "],["330104","","","","","","308","1","","","","Hip and femur fracture repair","I","$0.00 ","$9,132.60 ","$0.00 ","$9,132.60 ","$0.00 ","$0.00 ","$0.00 ","$8,675.97 ","$0.00 ","$8,767.29 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,689.73 ","$9,132.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,406.58 ","$0.00 ","$0.00 ","$12,785.64 ","$35,713.94 ","$9,132.60 ","$12,329.01 ","$11,233.10 ","$0.00 ","$9,406.58 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,132.60 ","$24,564.36 ","$10,959.12 ","$9,132.60 ","$9,132.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,132.60 ","$9,132.60 ","$10,502.49 ","$9,132.60 ","$0.00 ","$0.00 ","$35,713.94 "],["330104","","","","","","308","2","","","","Hip and femur fracture repair","I","$0.00 ","$12,467.39 ","$0.00 ","$12,467.39 ","$0.00 ","$0.00 ","$0.00 ","$11,844.02 ","$0.00 ","$11,968.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,958.26 ","$12,467.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,841.41 ","$0.00 ","$0.00 ","$17,454.35 ","$49,169.51 ","$12,467.39 ","$16,830.98 ","$15,334.89 ","$0.00 ","$12,841.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,467.39 ","$33,819.21 ","$14,960.87 ","$12,467.39 ","$12,467.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,467.39 ","$12,467.39 ","$14,337.50 ","$12,467.39 ","$0.00 ","$0.00 ","$49,169.51 "],["330104","","","","","","308","3","","","","Hip and femur fracture repair","I","$0.00 ","$18,477.57 ","$0.00 ","$18,477.57 ","$0.00 ","$0.00 ","$0.00 ","$17,553.69 ","$0.00 ","$17,738.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,651.29 ","$18,477.57 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,031.90 ","$0.00 ","$0.00 ","$25,868.60 ","$73,420.02 ","$18,477.57 ","$24,944.72 ","$22,727.41 ","$0.00 ","$19,031.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,477.57 ","$50,498.91 ","$22,173.08 ","$18,477.57 ","$18,477.57 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,477.57 ","$18,477.57 ","$21,249.21 ","$18,477.57 ","$0.00 ","$0.00 ","$73,420.02 "],["330104","","","","","","308","4","","","","Hip and femur fracture repair","I","$0.00 ","$38,512.17 ","$0.00 ","$38,512.17 ","$0.00 ","$0.00 ","$0.00 ","$36,586.56 ","$0.00 ","$36,971.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,295.58 ","$38,512.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,667.53 ","$0.00 ","$0.00 ","$53,917.04 ","$154,257.71 ","$38,512.17 ","$51,991.43 ","$47,369.97 ","$0.00 ","$39,667.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,512.17 ","$106,099.77 ","$46,214.60 ","$38,512.17 ","$38,512.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,512.17 ","$38,512.17 ","$44,288.99 ","$38,512.17 ","$0.00 ","$0.00 ","$154,257.71 "],["330104","","","","","","309","1","","","","Other significant hip and femur surgery","I","$0.00 ","$8,534.83 ","$0.00 ","$8,534.83 ","$0.00 ","$0.00 ","$0.00 ","$8,108.09 ","$0.00 ","$8,193.43 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,924.58 ","$8,534.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,790.87 ","$0.00 ","$0.00 ","$11,948.76 ","$33,302.00 ","$8,534.83 ","$11,522.02 ","$10,497.84 ","$0.00 ","$8,790.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,534.83 ","$22,905.40 ","$10,241.79 ","$8,534.83 ","$8,534.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,534.83 ","$8,534.83 ","$9,815.05 ","$8,534.83 ","$0.00 ","$0.00 ","$33,302.00 "],["330104","","","","","","309","2","","","","Other significant hip and femur surgery","I","$0.00 ","$12,705.97 ","$0.00 ","$12,705.97 ","$0.00 ","$0.00 ","$0.00 ","$12,070.67 ","$0.00 ","$12,197.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,263.64 ","$12,705.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,087.15 ","$0.00 ","$0.00 ","$17,788.36 ","$50,132.15 ","$12,705.97 ","$17,153.06 ","$15,628.34 ","$0.00 ","$13,087.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,705.97 ","$34,481.32 ","$15,247.16 ","$12,705.97 ","$12,705.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,705.97 ","$12,705.97 ","$14,611.86 ","$12,705.97 ","$0.00 ","$0.00 ","$50,132.15 "],["330104","","","","","","309","3","","","","Other significant hip and femur surgery","I","$0.00 ","$20,308.00 ","$0.00 ","$20,308.00 ","$0.00 ","$0.00 ","$0.00 ","$19,292.60 ","$0.00 ","$19,495.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,994.23 ","$20,308.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,917.23 ","$0.00 ","$0.00 ","$28,431.19 ","$80,805.61 ","$20,308.00 ","$27,415.79 ","$24,978.83 ","$0.00 ","$20,917.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,308.00 ","$55,578.78 ","$24,369.59 ","$20,308.00 ","$20,308.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,308.00 ","$20,308.00 ","$23,354.19 ","$20,308.00 ","$0.00 ","$0.00 ","$80,805.61 "],["330104","","","","","","309","4","","","","Other significant hip and femur surgery","I","$0.00 ","$38,355.10 ","$0.00 ","$38,355.10 ","$0.00 ","$0.00 ","$0.00 ","$36,437.35 ","$0.00 ","$36,820.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,094.53 ","$38,355.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,505.76 ","$0.00 ","$0.00 ","$53,697.15 ","$153,623.97 ","$38,355.10 ","$51,779.39 ","$47,176.78 ","$0.00 ","$39,505.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,355.10 ","$105,663.88 ","$46,026.13 ","$38,355.10 ","$38,355.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,355.10 ","$38,355.10 ","$44,108.37 ","$38,355.10 ","$0.00 ","$0.00 ","$153,623.97 "],["330104","","","","","","310","1","","","","Intervertebral disc excision & decompression","I","$0.00 ","$5,993.31 ","$0.00 ","$5,993.31 ","$0.00 ","$0.00 ","$0.00 ","$5,693.64 ","$0.00 ","$5,753.58 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,671.43 ","$5,993.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,173.11 ","$0.00 ","$0.00 ","$8,390.63 ","$23,047.21 ","$5,993.31 ","$8,090.97 ","$7,371.77 ","$0.00 ","$6,173.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,993.31 ","$15,852.06 ","$7,191.97 ","$5,993.31 ","$5,993.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,993.31 ","$5,993.31 ","$6,892.30 ","$5,993.31 ","$0.00 ","$0.00 ","$23,047.21 "],["330104","","","","","","310","2","","","","Intervertebral disc excision & decompression","I","$0.00 ","$8,379.75 ","$0.00 ","$8,379.75 ","$0.00 ","$0.00 ","$0.00 ","$7,960.76 ","$0.00 ","$8,044.56 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,726.08 ","$8,379.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,631.14 ","$0.00 ","$0.00 ","$11,731.65 ","$32,676.28 ","$8,379.75 ","$11,312.66 ","$10,307.09 ","$0.00 ","$8,631.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,379.75 ","$22,475.02 ","$10,055.70 ","$8,379.75 ","$8,379.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,379.75 ","$8,379.75 ","$9,636.71 ","$8,379.75 ","$0.00 ","$0.00 ","$32,676.28 "],["330104","","","","","","310","3","","","","Intervertebral disc excision & decompression","I","$0.00 ","$17,147.50 ","$0.00 ","$17,147.50 ","$0.00 ","$0.00 ","$0.00 ","$16,290.12 ","$0.00 ","$16,461.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,948.80 ","$17,147.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,661.92 ","$0.00 ","$0.00 ","$24,006.50 ","$68,053.30 ","$17,147.50 ","$23,149.12 ","$21,091.42 ","$0.00 ","$17,661.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,147.50 ","$46,807.64 ","$20,577.00 ","$17,147.50 ","$17,147.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,147.50 ","$17,147.50 ","$19,719.62 ","$17,147.50 ","$0.00 ","$0.00 ","$68,053.30 "],["330104","","","","","","310","4","","","","Intervertebral disc excision & decompression","I","$0.00 ","$45,625.77 ","$0.00 ","$45,625.77 ","$0.00 ","$0.00 ","$0.00 ","$43,344.48 ","$0.00 ","$43,800.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$58,400.99 ","$45,625.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$46,994.55 ","$0.00 ","$0.00 ","$63,876.08 ","$182,960.43 ","$45,625.77 ","$61,594.79 ","$56,119.70 ","$0.00 ","$46,994.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,625.77 ","$125,841.74 ","$54,750.93 ","$45,625.77 ","$45,625.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,625.77 ","$45,625.77 ","$52,469.64 ","$45,625.77 ","$0.00 ","$0.00 ","$182,960.43 "],["330104","","","","","","312","1","","","","Skin graft except hand for musculoskeletal & connective tissue diagnoses","I","$0.00 ","$8,359.21 ","$0.00 ","$8,359.21 ","$0.00 ","$0.00 ","$0.00 ","$7,941.25 ","$0.00 ","$8,024.84 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,699.79 ","$8,359.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,609.98 ","$0.00 ","$0.00 ","$11,702.89 ","$32,593.39 ","$8,359.21 ","$11,284.93 ","$10,281.83 ","$0.00 ","$8,609.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,359.21 ","$22,418.01 ","$10,031.05 ","$8,359.21 ","$8,359.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,359.21 ","$8,359.21 ","$9,613.09 ","$8,359.21 ","$0.00 ","$0.00 ","$32,593.39 "],["330104","","","","","","312","2","","","","Skin graft except hand for musculoskeletal & connective tissue diagnoses","I","$0.00 ","$15,214.35 ","$0.00 ","$15,214.35 ","$0.00 ","$0.00 ","$0.00 ","$14,453.63 ","$0.00 ","$14,605.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,474.37 ","$15,214.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,670.78 ","$0.00 ","$0.00 ","$21,300.09 ","$60,253.24 ","$15,214.35 ","$20,539.38 ","$18,713.65 ","$0.00 ","$15,670.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,214.35 ","$41,442.69 ","$18,257.22 ","$15,214.35 ","$15,214.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,214.35 ","$15,214.35 ","$17,496.50 ","$15,214.35 ","$0.00 ","$0.00 ","$60,253.24 "],["330104","","","","","","312","3","","","","Skin graft except hand for musculoskeletal & connective tissue diagnoses","I","$0.00 ","$30,287.19 ","$0.00 ","$30,287.19 ","$0.00 ","$0.00 ","$0.00 ","$28,772.83 ","$0.00 ","$29,075.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,767.60 ","$30,287.19 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$31,195.80 ","$0.00 ","$0.00 ","$42,402.06 ","$121,070.70 ","$30,287.19 ","$40,887.70 ","$37,253.24 ","$0.00 ","$31,195.80 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,287.19 ","$83,273.46 ","$36,344.63 ","$30,287.19 ","$30,287.19 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,287.19 ","$30,287.19 ","$34,830.27 ","$30,287.19 ","$0.00 ","$0.00 ","$121,070.70 "],["330104","","","","","","312","4","","","","Skin graft except hand for musculoskeletal & connective tissue diagnoses","I","$0.00 ","$59,941.12 ","$0.00 ","$59,941.12 ","$0.00 ","$0.00 ","$0.00 ","$56,944.07 ","$0.00 ","$57,543.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$76,724.64 ","$59,941.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$61,739.36 ","$0.00 ","$0.00 ","$83,917.57 ","$240,721.50 ","$59,941.12 ","$80,920.52 ","$73,727.58 ","$0.00 ","$61,739.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,941.12 ","$165,570.30 ","$71,929.35 ","$59,941.12 ","$59,941.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,941.12 ","$59,941.12 ","$68,932.29 ","$59,941.12 ","$0.00 ","$0.00 ","$240,721.50 "],["330104","","","","","","313","1","","","","Knee & lower leg procedures except foot","I","$0.00 ","$8,209.43 ","$0.00 ","$8,209.43 ","$0.00 ","$0.00 ","$0.00 ","$7,798.96 ","$0.00 ","$7,881.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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foot","I","$0.00 ","$43,167.76 ","$0.00 ","$43,167.76 ","$0.00 ","$0.00 ","$0.00 ","$41,009.37 ","$0.00 ","$41,441.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$55,254.73 ","$43,167.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$44,462.79 ","$0.00 ","$0.00 ","$60,434.86 ","$173,042.56 ","$43,167.76 ","$58,276.47 ","$53,096.34 ","$0.00 ","$44,462.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,167.76 ","$119,020.15 ","$51,801.31 ","$43,167.76 ","$43,167.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,167.76 ","$43,167.76 ","$49,642.92 ","$43,167.76 ","$0.00 ","$0.00 ","$173,042.56 "],["330104","","","","","","314","1","","","","Foot & toe procedures","I","$0.00 ","$7,295.55 ","$0.00 ","$7,295.55 ","$0.00 ","$0.00 ","$0.00 ","$6,930.77 ","$0.00 ","$7,003.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,338.30 ","$7,295.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,514.41 ","$0.00 ","$0.00 ","$10,213.77 ","$28,301.62 ","$7,295.55 ","$9,848.99 ","$8,973.52 ","$0.00 ","$7,514.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,295.55 ","$19,466.09 ","$8,754.66 ","$7,295.55 ","$7,295.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,295.55 ","$7,295.55 ","$8,389.88 ","$7,295.55 ","$0.00 ","$0.00 ","$28,301.62 "],["330104","","","","","","314","2","","","","Foot & toe procedures","I","$0.00 ","$9,256.53 ","$0.00 ","$9,256.53 ","$0.00 ","$0.00 ","$0.00 ","$8,793.70 ","$0.00 ","$8,886.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,848.35 ","$9,256.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,534.22 ","$0.00 ","$0.00 ","$12,959.14 ","$36,213.98 ","$9,256.53 ","$12,496.31 ","$11,385.53 ","$0.00 ","$9,534.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,256.53 ","$24,908.29 ","$11,107.83 ","$9,256.53 ","$9,256.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,256.53 ","$9,256.53 ","$10,645.01 ","$9,256.53 ","$0.00 ","$0.00 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replacement","I","$0.00 ","$17,963.96 ","$0.00 ","$17,963.96 ","$0.00 ","$0.00 ","$0.00 ","$17,065.77 ","$0.00 ","$17,245.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,993.88 ","$17,963.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,502.88 ","$0.00 ","$0.00 ","$25,149.55 ","$71,347.67 ","$17,963.96 ","$24,251.35 ","$22,095.68 ","$0.00 ","$18,502.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,963.96 ","$49,073.53 ","$21,556.76 ","$17,963.96 ","$17,963.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,963.96 ","$17,963.96 ","$20,658.56 ","$17,963.96 ","$0.00 ","$0.00 ","$71,347.67 "],["330104","","","","","","315","4","","","","Shoulder upper arm & forearm procedures except joint replacement","I","$0.00 ","$34,301.26 ","$0.00 ","$34,301.26 ","$0.00 ","$0.00 ","$0.00 ","$32,586.20 ","$0.00 ","$32,929.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,905.62 ","$34,301.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$35,330.30 ","$0.00 ","$0.00 ","$48,021.77 ","$137,267.12 ","$34,301.26 ","$46,306.71 ","$42,190.56 ","$0.00 ","$35,330.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$34,301.26 ","$94,413.49 ","$41,161.52 ","$34,301.26 ","$34,301.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$34,301.26 ","$34,301.26 ","$39,446.45 ","$34,301.26 ","$0.00 ","$0.00 ","$137,267.12 "],["330104","","","","","","316","1","","","","Hand & wrist procedures","I","$0.00 ","$5,029.72 ","$0.00 ","$5,029.72 ","$0.00 ","$0.00 ","$0.00 ","$4,778.23 ","$0.00 ","$4,828.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,438.04 ","$5,029.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,180.61 ","$0.00 ","$0.00 ","$7,041.60 ","$19,159.21 ","$5,029.72 ","$6,790.12 ","$6,186.55 ","$0.00 ","$5,180.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,029.72 ","$13,177.87 ","$6,035.66 ","$5,029.72 ","$5,029.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,029.72 ","$5,029.72 ","$5,784.17 ","$5,029.72 ","$0.00 ","$0.00 ","$19,159.21 "],["330104","","","","","","316","2","","","","Hand & wrist procedures","I","$0.00 ","$8,105.39 ","$0.00 ","$8,105.39 ","$0.00 ","$0.00 ","$0.00 ","$7,700.12 ","$0.00 ","$7,781.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,374.90 ","$8,105.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,348.55 ","$0.00 ","$0.00 ","$11,347.54 ","$31,569.24 ","$8,105.39 ","$10,942.27 ","$9,969.63 ","$0.00 ","$8,348.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,105.39 ","$21,713.60 ","$9,726.46 ","$8,105.39 ","$8,105.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,105.39 ","$8,105.39 ","$9,321.19 ","$8,105.39 ","$0.00 ","$0.00 ","$31,569.24 "],["330104","","","","","","316","3","","","","Hand & wrist procedures","I","$0.00 ","$14,417.77 ","$0.00 ","$14,417.77 ","$0.00 ","$0.00 ","$0.00 ","$13,696.88 ","$0.00 ","$13,841.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,454.74 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","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,103.06 ","$16,103.06 ","$18,518.51 ","$16,103.06 ","$0.00 ","$0.00 ","$63,839.08 "],["330104","","","","","","317","1","","","","Tendon muscle & other soft tissue procedures","I","$0.00 ","$6,244.48 ","$0.00 ","$6,244.48 ","$0.00 ","$0.00 ","$0.00 ","$5,932.25 ","$0.00 ","$5,994.70 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,992.93 ","$6,244.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,431.81 ","$0.00 ","$0.00 ","$8,742.27 ","$24,060.65 ","$6,244.48 ","$8,430.04 ","$7,680.71 ","$0.00 ","$6,431.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,244.48 ","$16,549.12 ","$7,493.37 ","$6,244.48 ","$6,244.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,244.48 ","$6,244.48 ","$7,181.15 ","$6,244.48 ","$0.00 ","$0.00 ","$24,060.65 "],["330104","","","","","","317","2","","","","Tendon muscle & other soft tissue procedures","I","$0.00 ","$9,790.68 ","$0.00 ","$9,790.68 ","$0.00 ","$0.00 ","$0.00 ","$9,301.14 ","$0.00 ","$9,399.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,532.07 ","$9,790.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,084.40 ","$0.00 ","$0.00 ","$13,706.95 ","$38,369.23 ","$9,790.68 ","$13,217.41 ","$12,042.53 ","$0.00 ","$10,084.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,790.68 ","$26,390.68 ","$11,748.81 ","$9,790.68 ","$9,790.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,790.68 ","$9,790.68 ","$11,259.28 ","$9,790.68 ","$0.00 ","$0.00 ","$38,369.23 "],["330104","","","","","","317","3","","","","Tendon muscle & other soft tissue procedures","I","$0.00 ","$17,563.68 ","$0.00 ","$17,563.68 ","$0.00 ","$0.00 ","$0.00 ","$16,685.50 ","$0.00 ","$16,861.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,481.52 ","$17,563.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,090.59 ","$0.00 ","$0.00 ","$24,589.16 ","$69,732.57 ","$17,563.68 ","$23,710.97 ","$21,603.33 ","$0.00 ","$18,090.59 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,563.68 ","$47,962.66 ","$21,076.42 ","$17,563.68 ","$17,563.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,563.68 ","$17,563.68 ","$20,198.24 ","$17,563.68 ","$0.00 ","$0.00 ","$69,732.57 "],["330104","","","","","","317","4","","","","Tendon muscle & other soft tissue procedures","I","$0.00 ","$42,151.81 ","$0.00 ","$42,151.81 ","$0.00 ","$0.00 ","$0.00 ","$40,044.22 ","$0.00 ","$40,465.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$53,954.32 ","$42,151.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,416.36 ","$0.00 ","$0.00 ","$59,012.53 ","$168,943.32 ","$42,151.81 ","$56,904.94 ","$51,846.73 ","$0.00 ","$43,416.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,151.81 ","$116,200.66 ","$50,582.17 ","$42,151.81 ","$42,151.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,151.81 ","$42,151.81 ","$48,474.58 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","$0.00 ","$0.00 ","$0.00 ","$18,573.50 ","$14,510.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,945.86 ","$0.00 ","$0.00 ","$20,314.77 ","$57,413.45 ","$14,510.55 ","$19,589.24 ","$17,847.97 ","$0.00 ","$14,945.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,510.55 ","$39,489.46 ","$17,412.66 ","$14,510.55 ","$14,510.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,510.55 ","$14,510.55 ","$16,687.13 ","$14,510.55 ","$0.00 ","$0.00 ","$57,413.45 "],["330104","","","","","","321","3","","","","Cervical spinal fusion & other back\/neck proc exc disc excis\/decomp","I","$0.00 ","$24,819.11 ","$0.00 ","$24,819.11 ","$0.00 ","$0.00 ","$0.00 ","$23,578.15 ","$0.00 ","$23,826.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$31,768.46 ","$24,819.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,563.68 ","$0.00 ","$0.00 ","$34,746.75 ","$99,007.52 ","$24,819.11 ","$33,505.80 ","$30,527.50 ","$0.00 ","$25,563.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,819.11 ","$68,098.22 ","$29,782.93 ","$24,819.11 ","$24,819.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,819.11 ","$24,819.11 ","$28,541.98 ","$24,819.11 ","$0.00 ","$0.00 ","$99,007.52 "],["330104","","","","","","321","4","","","","Cervical spinal fusion & other back\/neck proc exc disc excis\/decomp","I","$0.00 ","$47,097.00 ","$0.00 ","$47,097.00 ","$0.00 ","$0.00 ","$0.00 ","$44,742.15 ","$0.00 ","$45,213.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$60,284.17 ","$47,097.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$48,509.91 ","$0.00 ","$0.00 ","$65,935.81 ","$188,896.71 ","$47,097.00 ","$63,580.96 ","$57,929.32 ","$0.00 ","$48,509.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$47,097.00 ","$129,924.77 ","$56,516.41 ","$47,097.00 ","$47,097.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$47,097.00 ","$47,097.00 ","$54,161.55 ","$47,097.00 ","$0.00 ","$0.00 ","$188,896.71 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","$0.00 ","$3,595.88 ","$0.00 ","$3,633.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,844.97 ","$3,785.13 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,898.69 ","$0.00 ","$0.00 ","$5,299.19 ","$14,137.44 ","$3,785.13 ","$5,109.93 ","$4,655.72 ","$0.00 ","$3,898.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,785.13 ","$9,723.85 ","$4,542.16 ","$3,785.13 ","$3,785.13 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,785.13 ","$3,785.13 ","$4,352.90 ","$3,785.13 ","$0.00 ","$0.00 ","$14,137.44 "],["330104","","","","","","340","2","","","","Fracture of femur","I","$0.00 ","$4,974.05 ","$0.00 ","$4,974.05 ","$0.00 ","$0.00 ","$0.00 ","$4,725.35 ","$0.00 ","$4,775.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,366.78 ","$4,974.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,123.27 ","$0.00 ","$0.00 ","$6,963.67 ","$18,934.59 ","$4,974.05 ","$6,714.97 ","$6,118.08 ","$0.00 ","$5,123.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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femur","I","$0.00 ","$15,643.79 ","$0.00 ","$15,643.79 ","$0.00 ","$0.00 ","$0.00 ","$14,861.60 ","$0.00 ","$15,018.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,024.05 ","$15,643.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,113.11 ","$0.00 ","$0.00 ","$21,901.31 ","$61,985.99 ","$15,643.79 ","$21,119.12 ","$19,241.87 ","$0.00 ","$16,113.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,643.79 ","$42,634.50 ","$18,772.55 ","$15,643.79 ","$15,643.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,643.79 ","$15,643.79 ","$17,990.36 ","$15,643.79 ","$0.00 ","$0.00 ","$61,985.99 "],["330104","","","","","","341","1","","","","Fracture of pelvis or dislocation of hip","I","$0.00 ","$4,075.40 ","$0.00 ","$4,075.40 ","$0.00 ","$0.00 ","$0.00 ","$3,871.63 ","$0.00 ","$3,912.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,216.52 ","$4,075.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,197.67 ","$0.00 ","$0.00 ","$5,705.57 ","$15,308.65 ","$4,075.40 ","$5,501.80 ","$5,012.75 ","$0.00 ","$4,197.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,075.40 ","$10,529.42 ","$4,890.49 ","$4,075.40 ","$4,075.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,075.40 ","$4,075.40 ","$4,686.72 ","$4,075.40 ","$0.00 ","$0.00 ","$15,308.65 "],["330104","","","","","","341","2","","","","Fracture of pelvis or dislocation of hip","I","$0.00 ","$5,011.82 ","$0.00 ","$5,011.82 ","$0.00 ","$0.00 ","$0.00 ","$4,761.23 ","$0.00 ","$4,811.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,415.13 ","$5,011.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,162.18 ","$0.00 ","$0.00 ","$7,016.55 ","$19,087.01 ","$5,011.82 ","$6,765.96 ","$6,164.54 ","$0.00 ","$5,162.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,011.82 ","$13,128.21 ","$6,014.19 ","$5,011.82 ","$5,011.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,011.82 ","$5,011.82 ","$5,763.60 ","$5,011.82 ","$0.00 ","$0.00 ","$19,087.01 "],["330104","","","","","","341","3","","","","Fracture of pelvis or dislocation of hip","I","$0.00 ","$6,657.35 ","$0.00 ","$6,657.35 ","$0.00 ","$0.00 ","$0.00 ","$6,324.48 ","$0.00 ","$6,391.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,521.41 ","$6,657.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,857.07 ","$0.00 ","$0.00 ","$9,320.29 ","$25,726.55 ","$6,657.35 ","$8,987.42 ","$8,188.54 ","$0.00 ","$6,857.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,657.35 ","$17,694.94 ","$7,988.82 ","$6,657.35 ","$6,657.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,657.35 ","$6,657.35 ","$7,655.95 ","$6,657.35 ","$0.00 ","$0.00 ","$25,726.55 "],["330104","","","","","","341","4","","","","Fracture of pelvis or dislocation of hip","I","$0.00 ","$7,066.25 ","$0.00 ","$7,066.25 ","$0.00 ","$0.00 ","$0.00 ","$6,712.93 ","$0.00 ","$6,783.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,044.80 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","$8,245.74 ","$7,512.79 ","$0.00 ","$6,291.20 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,107.96 ","$16,170.25 ","$7,329.55 ","$6,107.96 ","$6,107.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,107.96 ","$6,107.96 ","$7,024.15 ","$6,107.96 ","$0.00 ","$0.00 ","$23,509.81 "],["330104","","","","","","349","3","","","","Malfunction reaction complic of orthopedic device or procedure","I","$0.00 ","$10,606.48 ","$0.00 ","$10,606.48 ","$0.00 ","$0.00 ","$0.00 ","$10,076.16 ","$0.00 ","$10,182.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,576.30 ","$10,606.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,924.68 ","$0.00 ","$0.00 ","$14,849.07 ","$41,660.92 ","$10,606.48 ","$14,318.75 ","$13,045.97 ","$0.00 ","$10,924.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,606.48 ","$28,654.74 ","$12,727.78 ","$10,606.48 ","$10,606.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,606.48 ","$10,606.48 ","$12,197.45 ","$10,606.48 ","$0.00 ","$0.00 ","$41,660.92 "],["330104","","","","","","349","4","","","","Malfunction reaction complic of orthopedic device or procedure","I","$0.00 ","$23,949.62 ","$0.00 ","$23,949.62 ","$0.00 ","$0.00 ","$0.00 ","$22,752.14 ","$0.00 ","$22,991.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,655.52 ","$23,949.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,668.11 ","$0.00 ","$0.00 ","$33,529.47 ","$95,499.24 ","$23,949.62 ","$32,331.99 ","$29,458.04 ","$0.00 ","$24,668.11 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,949.62 ","$65,685.19 ","$28,739.55 ","$23,949.62 ","$23,949.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,949.62 ","$23,949.62 ","$27,542.07 ","$23,949.62 ","$0.00 ","$0.00 ","$95,499.24 "],["330104","","","","","","351","1","","","","Other musculoskeletal system & connective tissue diagnoses","I","$0.00 ","$3,534.63 ","$0.00 ","$3,534.63 ","$0.00 ","$0.00 ","$0.00 ","$3,357.90 ","$0.00 ","$3,393.24 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,524.32 ","$3,534.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,640.67 ","$0.00 ","$0.00 ","$4,948.48 ","$13,126.67 ","$3,534.63 ","$4,771.75 ","$4,347.59 ","$0.00 ","$3,640.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,534.63 ","$9,028.63 ","$4,241.55 ","$3,534.63 ","$3,534.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,534.63 ","$3,534.63 ","$4,064.82 ","$3,534.63 ","$0.00 ","$0.00 ","$13,126.67 "],["330104","","","","","","351","2","","","","Other musculoskeletal system & connective tissue diagnoses","I","$0.00 ","$4,514.79 ","$0.00 ","$4,514.79 ","$0.00 ","$0.00 ","$0.00 ","$4,289.05 ","$0.00 ","$4,334.19 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,778.93 ","$4,514.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,650.23 ","$0.00 ","$0.00 ","$6,320.70 ","$17,081.51 ","$4,514.79 ","$6,094.96 ","$5,553.19 ","$0.00 ","$4,650.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,514.79 ","$11,748.81 ","$5,417.74 ","$4,514.79 ","$4,514.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,514.79 ","$4,514.79 ","$5,192.00 ","$4,514.79 ","$0.00 ","$0.00 ","$17,081.51 "],["330104","","","","","","351","3","","","","Other musculoskeletal system & connective tissue diagnoses","I","$0.00 ","$7,933.74 ","$0.00 ","$7,933.74 ","$0.00 ","$0.00 ","$0.00 ","$7,537.06 ","$0.00 ","$7,616.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,155.19 ","$7,933.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,171.76 ","$0.00 ","$0.00 ","$11,107.24 ","$30,876.68 ","$7,933.74 ","$10,710.55 ","$9,758.50 ","$0.00 ","$8,171.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,933.74 ","$21,237.24 ","$9,520.49 ","$7,933.74 ","$7,933.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,933.74 ","$7,933.74 ","$9,123.80 ","$7,933.74 ","$0.00 ","$0.00 ","$30,876.68 "],["330104","","","","","","351","4","","","","Other musculoskeletal system & connective tissue diagnoses","I","$0.00 ","$20,696.35 ","$0.00 ","$20,696.35 ","$0.00 ","$0.00 ","$0.00 ","$19,661.53 ","$0.00 ","$19,868.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$26,491.32 ","$20,696.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,317.24 ","$0.00 ","$0.00 ","$28,974.89 ","$82,372.57 ","$20,696.35 ","$27,940.07 ","$25,456.51 ","$0.00 ","$21,317.24 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,696.35 ","$56,656.56 ","$24,835.62 ","$20,696.35 ","$20,696.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,696.35 ","$20,696.35 ","$23,800.80 ","$20,696.35 ","$0.00 ","$0.00 ","$82,372.57 "],["330104","","","","","","361","1","","","","Skin graft for skin & subcutaneous tissue diagnoses","I","$0.00 ","$9,070.97 ","$0.00 ","$9,070.97 ","$0.00 ","$0.00 ","$0.00 ","$8,617.42 ","$0.00 ","$8,708.13 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,610.84 ","$9,070.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,343.09 ","$0.00 ","$0.00 ","$12,699.35 ","$35,465.26 ","$9,070.97 ","$12,245.80 ","$11,157.29 ","$0.00 ","$9,343.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,070.97 ","$24,393.31 ","$10,885.16 ","$9,070.97 ","$9,070.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,070.97 ","$9,070.97 ","$10,431.61 ","$9,070.97 ","$0.00 ","$0.00 ","$35,465.26 "],["330104","","","","","","361","2","","","","Skin graft for skin & subcutaneous tissue diagnoses","I","$0.00 ","$12,726.51 ","$0.00 ","$12,726.51 ","$0.00 ","$0.00 ","$0.00 ","$12,090.19 ","$0.00 ","$12,217.45 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,289.94 ","$12,726.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,108.31 ","$0.00 ","$0.00 ","$17,817.12 ","$50,215.05 ","$12,726.51 ","$17,180.79 ","$15,653.61 ","$0.00 ","$13,108.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,726.51 ","$34,538.34 ","$15,271.82 ","$12,726.51 ","$12,726.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,726.51 ","$12,726.51 ","$14,635.49 ","$12,726.51 ","$0.00 ","$0.00 ","$50,215.05 "],["330104","","","","","","361","3","","","","Skin graft for skin & subcutaneous tissue diagnoses","I","$0.00 ","$22,414.77 ","$0.00 ","$22,414.77 ","$0.00 ","$0.00 ","$0.00 ","$21,294.03 ","$0.00 ","$21,518.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$28,690.91 ","$22,414.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,087.22 ","$0.00 ","$0.00 ","$31,380.68 ","$89,306.25 ","$22,414.77 ","$30,259.94 ","$27,570.17 ","$0.00 ","$23,087.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,414.77 ","$61,425.60 ","$26,897.73 ","$22,414.77 ","$22,414.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,414.77 ","$22,414.77 ","$25,776.99 ","$22,414.77 ","$0.00 ","$0.00 ","$89,306.25 "],["330104","","","","","","361","4","","","","Skin graft for skin & subcutaneous tissue diagnoses","I","$0.00 ","$63,905.50 ","$0.00 ","$63,905.50 ","$0.00 ","$0.00 ","$0.00 ","$60,710.22 ","$0.00 ","$61,349.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$81,799.03 ","$63,905.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$65,822.66 ","$0.00 ","$0.00 ","$89,467.69 ","$256,717.37 ","$63,905.50 ","$86,272.42 ","$78,603.76 ","$0.00 ","$65,822.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$63,905.50 ","$176,572.40 ","$76,686.59 ","$63,905.50 ","$63,905.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$63,905.50 ","$63,905.50 ","$73,491.32 ","$63,905.50 ","$0.00 ","$0.00 ","$256,717.37 "],["330104","","","","","","362","1","","","","Mastectomy procedures","I","$0.00 ","$9,318.82 ","$0.00 ","$9,318.82 ","$0.00 ","$0.00 ","$0.00 ","$8,852.88 ","$0.00 ","$8,946.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,928.09 ","$9,318.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,598.39 ","$0.00 ","$0.00 ","$13,046.35 ","$36,465.34 ","$9,318.82 ","$12,580.41 ","$11,462.15 ","$0.00 ","$9,598.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,318.82 ","$25,081.17 ","$11,182.59 ","$9,318.82 ","$9,318.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,318.82 ","$9,318.82 ","$10,716.64 ","$9,318.82 ","$0.00 ","$0.00 ","$36,465.34 "],["330104","","","","","","362","2","","","","Mastectomy procedures","I","$0.00 ","$12,245.38 ","$0.00 ","$12,245.38 ","$0.00 ","$0.00 ","$0.00 ","$11,633.11 ","$0.00 ","$11,755.56 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,674.09 ","$12,245.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,612.74 ","$0.00 ","$0.00 ","$17,143.53 ","$48,273.72 ","$12,245.38 ","$16,531.26 ","$15,061.82 ","$0.00 ","$12,612.74 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,245.38 ","$33,203.08 ","$14,694.46 ","$12,245.38 ","$12,245.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,245.38 ","$12,245.38 ","$14,082.19 ","$12,245.38 ","$0.00 ","$0.00 ","$48,273.72 "],["330104","","","","","","362","3","","","","Mastectomy procedures","I","$0.00 ","$18,693.62 ","$0.00 ","$18,693.62 ","$0.00 ","$0.00 ","$0.00 ","$17,758.94 ","$0.00 ","$17,945.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,927.83 ","$18,693.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,254.42 ","$0.00 ","$0.00 ","$26,171.06 ","$74,291.74 ","$18,693.62 ","$25,236.38 ","$22,993.15 ","$0.00 ","$19,254.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,693.62 ","$51,098.49 ","$22,432.34 ","$18,693.62 ","$18,693.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,693.62 ","$18,693.62 ","$21,497.66 ","$18,693.62 ","$0.00 ","$0.00 ","$74,291.74 "],["330104","","","","","","362","4","","","","Mastectomy procedures","I","$0.00 ","$19,524.66 ","$0.00 ","$19,524.66 ","$0.00 ","$0.00 ","$0.00 ","$18,548.43 ","$0.00 ","$18,743.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,991.57 ","$19,524.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,110.40 ","$0.00 ","$0.00 ","$27,334.53 ","$77,644.94 ","$19,524.66 ","$26,358.30 ","$24,015.34 ","$0.00 ","$20,110.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,524.66 ","$53,404.85 ","$23,429.60 ","$19,524.66 ","$19,524.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,524.66 ","$19,524.66 ","$22,453.36 ","$19,524.66 ","$0.00 ","$0.00 ","$77,644.94 "],["330104","","","","","","363","1","","","","Breast procedures except mastectomy","I","$0.00 ","$6,280.93 ","$0.00 ","$6,280.93 ","$0.00 ","$0.00 ","$0.00 ","$5,966.88 ","$0.00 ","$6,029.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,039.59 ","$6,280.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,469.35 ","$0.00 ","$0.00 ","$8,793.30 ","$24,207.72 ","$6,280.93 ","$8,479.25 ","$7,725.54 ","$0.00 ","$6,469.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,280.93 ","$16,650.28 ","$7,537.11 ","$6,280.93 ","$6,280.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,280.93 ","$6,280.93 ","$7,223.07 ","$6,280.93 ","$0.00 ","$0.00 ","$24,207.72 "],["330104","","","","","","363","2","","","","Breast procedures except mastectomy","I","$0.00 ","$10,344.04 ","$0.00 ","$10,344.04 ","$0.00 ","$0.00 ","$0.00 ","$9,826.84 ","$0.00 ","$9,930.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,240.38 ","$10,344.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,654.37 ","$0.00 ","$0.00 ","$14,481.66 ","$40,602.02 ","$10,344.04 ","$13,964.46 ","$12,723.18 ","$0.00 ","$10,654.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,344.04 ","$27,926.41 ","$12,412.85 ","$10,344.04 ","$10,344.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,344.04 ","$10,344.04 ","$11,895.65 ","$10,344.04 ","$0.00 ","$0.00 ","$40,602.02 "],["330104","","","","","","363","3","","","","Breast procedures except mastectomy","I","$0.00 ","$15,492.69 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except hypovolemia related","I","$0.00 ","$16,789.63 ","$0.00 ","$16,789.63 ","$0.00 ","$0.00 ","$0.00 ","$15,950.15 ","$0.00 ","$16,118.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,490.73 ","$16,789.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,293.32 ","$0.00 ","$0.00 ","$23,505.48 ","$66,609.34 ","$16,789.63 ","$22,666.00 ","$20,651.25 ","$0.00 ","$17,293.32 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,789.63 ","$45,814.47 ","$20,147.56 ","$16,789.63 ","$16,789.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,789.63 ","$16,789.63 ","$19,308.08 ","$16,789.63 ","$0.00 ","$0.00 ","$66,609.34 "],["330104","","","","","","440","1","","","","Kidney transplant","I","$0.00 ","$24,841.64 ","$0.00 ","$24,841.64 ","$0.00 ","$0.00 ","$0.00 ","$23,599.56 ","$0.00 ","$23,847.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$31,797.30 ","$24,841.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,586.89 ","$0.00 ","$0.00 ","$34,778.30 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","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,102.89 ","$124,390.61 ","$54,123.47 ","$45,102.89 ","$45,102.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$45,102.89 ","$45,102.89 ","$51,868.32 ","$45,102.89 ","$0.00 ","$0.00 ","$180,850.64 "],["330104","","","","","","442","1","","","","Kidney & urinary tract procedures for malignancy","I","$0.00 ","$8,856.91 ","$0.00 ","$8,856.91 ","$0.00 ","$0.00 ","$0.00 ","$8,414.06 ","$0.00 ","$8,502.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,336.84 ","$8,856.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,122.62 ","$0.00 ","$0.00 ","$12,399.67 ","$34,601.56 ","$8,856.91 ","$11,956.83 ","$10,894.00 ","$0.00 ","$9,122.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,856.91 ","$23,799.25 ","$10,628.29 ","$8,856.91 ","$8,856.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,856.91 ","$8,856.91 ","$10,185.44 ","$8,856.91 ","$0.00 ","$0.00 ","$34,601.56 "],["330104","","","","","","442","2","","","","Kidney & urinary tract procedures for malignancy","I","$0.00 ","$10,469.30 ","$0.00 ","$10,469.30 ","$0.00 ","$0.00 ","$0.00 ","$9,945.83 ","$0.00 ","$10,050.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,400.70 ","$10,469.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,783.38 ","$0.00 ","$0.00 ","$14,657.02 ","$41,107.40 ","$10,469.30 ","$14,133.55 ","$12,877.24 ","$0.00 ","$10,783.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,469.30 ","$28,274.02 ","$12,563.16 ","$10,469.30 ","$10,469.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,469.30 ","$10,469.30 ","$12,039.69 ","$10,469.30 ","$0.00 ","$0.00 ","$41,107.40 "],["330104","","","","","","442","3","","","","Kidney & urinary tract procedures for malignancy","I","$0.00 ","$18,941.47 ","$0.00 ","$18,941.47 ","$0.00 ","$0.00 ","$0.00 ","$17,994.40 ","$0.00 ","$18,183.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,245.08 ","$18,941.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,509.72 ","$0.00 ","$0.00 ","$26,518.06 ","$75,291.82 ","$18,941.47 ","$25,570.99 ","$23,298.01 ","$0.00 ","$19,509.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,941.47 ","$51,786.35 ","$22,729.77 ","$18,941.47 ","$18,941.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,941.47 ","$18,941.47 ","$21,782.69 ","$18,941.47 ","$0.00 ","$0.00 ","$75,291.82 "],["330104","","","","","","442","4","","","","Kidney & urinary tract procedures for malignancy","I","$0.00 ","$42,535.52 ","$0.00 ","$42,535.52 ","$0.00 ","$0.00 ","$0.00 ","$40,408.75 ","$0.00 ","$40,834.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$54,445.47 ","$42,535.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,811.59 ","$0.00 ","$0.00 ","$59,549.73 ","$170,491.57 ","$42,535.52 ","$57,422.96 ","$52,318.69 ","$0.00 ","$43,811.59 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,535.52 ","$117,265.55 ","$51,042.63 ","$42,535.52 ","$42,535.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,535.52 ","$42,535.52 ","$48,915.85 ","$42,535.52 ","$0.00 ","$0.00 ","$170,491.57 "],["330104","","","","","","443","1","","","","Kidney & urinary tract procedures for nonmalignancy","I","$0.00 ","$7,388.99 ","$0.00 ","$7,388.99 ","$0.00 ","$0.00 ","$0.00 ","$7,019.54 ","$0.00 ","$7,093.43 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,457.91 ","$7,388.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,610.66 ","$0.00 ","$0.00 ","$10,344.59 ","$28,678.65 ","$7,388.99 ","$9,975.14 ","$9,088.46 ","$0.00 ","$7,610.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,388.99 ","$19,725.42 ","$8,866.79 ","$7,388.99 ","$7,388.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,388.99 ","$7,388.99 ","$8,497.34 ","$7,388.99 ","$0.00 ","$0.00 ","$28,678.65 "],["330104","","","","","","443","2","","","","Kidney & urinary tract procedures for nonmalignancy","I","$0.00 ","$8,180.27 ","$0.00 ","$8,180.27 ","$0.00 ","$0.00 ","$0.00 ","$7,771.26 ","$0.00 ","$7,853.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,470.75 ","$8,180.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,425.68 ","$0.00 ","$0.00 ","$11,452.38 ","$31,871.41 ","$8,180.27 ","$11,043.37 ","$10,061.74 ","$0.00 ","$8,425.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,180.27 ","$21,921.42 ","$9,816.33 ","$8,180.27 ","$8,180.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,180.27 ","$8,180.27 ","$9,407.32 ","$8,180.27 ","$0.00 ","$0.00 ","$31,871.41 "],["330104","","","","","","443","3","","","","Kidney & urinary tract procedures for nonmalignancy","I","$0.00 ","$15,336.95 ","$0.00 ","$15,336.95 ","$0.00 ","$0.00 ","$0.00 ","$14,570.11 ","$0.00 ","$14,723.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,631.30 ","$15,336.95 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,797.06 ","$0.00 ","$0.00 ","$21,471.74 ","$60,747.93 ","$15,336.95 ","$20,704.89 ","$18,864.45 ","$0.00 ","$15,797.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,336.95 ","$41,782.95 ","$18,404.35 ","$15,336.95 ","$15,336.95 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,336.95 ","$15,336.95 ","$17,637.50 ","$15,336.95 ","$0.00 ","$0.00 ","$60,747.93 "],["330104","","","","","","443","4","","","","Kidney & urinary tract procedures for nonmalignancy","I","$0.00 ","$33,866.52 ","$0.00 ","$33,866.52 ","$0.00 ","$0.00 ","$0.00 ","$32,173.20 ","$0.00 ","$32,511.86 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,349.15 ","$33,866.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$34,882.52 ","$0.00 ","$0.00 ","$47,413.13 ","$135,512.97 ","$33,866.52 ","$45,719.80 ","$41,655.82 ","$0.00 ","$34,882.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,866.52 ","$93,206.98 ","$40,639.83 ","$33,866.52 ","$33,866.52 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,866.52 ","$33,866.52 ","$38,946.50 ","$33,866.52 ","$0.00 ","$0.00 ","$135,512.97 "],["330104","","","","","","444","1","","","","Renal dialysis access device procedure only","I","$0.00 ","$6,791.88 ","$0.00 ","$6,791.88 ","$0.00 ","$0.00 ","$0.00 ","$6,452.29 ","$0.00 ","$6,520.21 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,693.61 ","$6,791.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,995.64 ","$0.00 ","$0.00 ","$9,508.63 ","$26,269.38 ","$6,791.88 ","$9,169.04 ","$8,354.01 ","$0.00 ","$6,995.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,791.88 ","$18,068.30 ","$8,150.26 ","$6,791.88 ","$6,791.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,791.88 ","$6,791.88 ","$7,810.66 ","$6,791.88 ","$0.00 ","$0.00 ","$26,269.38 "],["330104","","","","","","444","2","","","","Renal dialysis access device procedure only","I","$0.00 ","$11,858.35 ","$0.00 ","$11,858.35 ","$0.00 ","$0.00 ","$0.00 ","$11,265.44 ","$0.00 ","$11,384.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,178.69 ","$11,858.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,214.10 ","$0.00 ","$0.00 ","$16,601.69 ","$46,712.11 ","$11,858.35 ","$16,008.78 ","$14,585.77 ","$0.00 ","$12,214.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,858.35 ","$32,128.98 ","$14,230.02 ","$11,858.35 ","$11,858.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,858.35 ","$11,858.35 ","$13,637.11 ","$11,858.35 ","$0.00 ","$0.00 ","$46,712.11 "],["330104","","","","","","444","3","","","","Renal dialysis access device procedure only","I","$0.00 ","$21,704.34 ","$0.00 ","$21,704.34 ","$0.00 ","$0.00 ","$0.00 ","$20,619.12 ","$0.00 ","$20,836.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,781.55 ","$21,704.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,355.47 ","$0.00 ","$0.00 ","$30,386.08 ","$86,439.72 ","$21,704.34 ","$29,300.86 ","$26,696.34 ","$0.00 ","$22,355.47 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,704.34 ","$59,453.98 ","$26,045.21 ","$21,704.34 ","$21,704.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,704.34 ","$21,704.34 ","$24,959.99 ","$21,704.34 ","$0.00 ","$0.00 ","$86,439.72 "],["330104","","","","","","444","4","","","","Renal dialysis access device procedure only","I","$0.00 ","$41,276.36 ","$0.00 ","$41,276.36 ","$0.00 ","$0.00 ","$0.00 ","$39,212.54 ","$0.00 ","$39,625.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$52,833.74 ","$41,276.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,514.65 ","$0.00 ","$0.00 ","$57,786.91 ","$165,410.97 ","$41,276.36 ","$55,723.09 ","$50,769.92 ","$0.00 ","$42,514.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,276.36 ","$113,771.07 ","$49,531.63 ","$41,276.36 ","$41,276.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,276.36 ","$41,276.36 ","$47,467.82 ","$41,276.36 ","$0.00 ","$0.00 ","$165,410.97 "],["330104","","","","","","445","1","","","","Other bladder procedures","I","$0.00 ","$5,724.91 ","$0.00 ","$5,724.91 ","$0.00 ","$0.00 ","$0.00 ","$5,438.66 ","$0.00 ","$5,495.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,327.88 ","$5,724.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,896.65 ","$0.00 ","$0.00 ","$8,014.87 ","$21,964.24 ","$5,724.91 ","$7,728.63 ","$7,041.64 ","$0.00 ","$5,896.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,724.91 ","$15,107.19 ","$6,869.89 ","$5,724.91 ","$5,724.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,724.91 ","$5,724.91 ","$6,583.64 ","$5,724.91 ","$0.00 ","$0.00 ","$21,964.24 "],["330104","","","","","","445","2","","","","Other bladder procedures","I","$0.00 ","$8,691.89 ","$0.00 ","$8,691.89 ","$0.00 ","$0.00 ","$0.00 ","$8,257.30 ","$0.00 ","$8,344.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,125.62 ","$8,691.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,952.65 ","$0.00 ","$0.00 ","$12,168.65 ","$33,935.73 ","$8,691.89 ","$11,734.05 ","$10,691.03 ","$0.00 ","$8,952.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,691.89 ","$23,341.29 ","$10,430.27 ","$8,691.89 ","$8,691.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,691.89 ","$8,691.89 ","$9,995.68 ","$8,691.89 ","$0.00 ","$0.00 ","$33,935.73 "],["330104","","","","","","445","3","","","","Other bladder procedures","I","$0.00 ","$12,692.71 ","$0.00 ","$12,692.71 ","$0.00 ","$0.00 ","$0.00 ","$12,058.08 ","$0.00 ","$12,185.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,246.67 ","$12,692.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,073.50 ","$0.00 ","$0.00 ","$17,769.80 ","$50,078.67 ","$12,692.71 ","$17,135.16 ","$15,612.04 ","$0.00 ","$13,073.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,692.71 ","$34,444.54 ","$15,231.26 ","$12,692.71 ","$12,692.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,692.71 ","$12,692.71 ","$14,596.62 ","$12,692.71 ","$0.00 ","$0.00 ","$50,078.67 "],["330104","","","","","","445","4","","","","Other bladder procedures","I","$0.00 ","$16,515.27 ","$0.00 ","$16,515.27 ","$0.00 ","$0.00 ","$0.00 ","$15,689.50 ","$0.00 ","$15,854.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,139.54 ","$16,515.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,010.72 ","$0.00 ","$0.00 ","$23,121.37 ","$65,502.30 ","$16,515.27 ","$22,295.61 ","$20,313.78 ","$0.00 ","$17,010.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,515.27 ","$45,053.04 ","$19,818.32 ","$16,515.27 ","$16,515.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,515.27 ","$16,515.27 ","$18,992.56 ","$16,515.27 ","$0.00 ","$0.00 ","$65,502.30 "],["330104","","","","","","446","1","","","","Urethral & transurethral procedures","I","$0.00 ","$4,817.65 ","$0.00 ","$4,817.65 ","$0.00 ","$0.00 ","$0.00 ","$4,576.77 ","$0.00 ","$4,624.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,166.59 ","$4,817.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,962.18 ","$0.00 ","$0.00 ","$6,744.71 ","$18,303.53 ","$4,817.65 ","$6,503.82 ","$5,925.71 ","$0.00 ","$4,962.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,817.65 ","$12,589.32 ","$5,781.18 ","$4,817.65 ","$4,817.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,817.65 ","$4,817.65 ","$5,540.30 ","$4,817.65 ","$0.00 ","$0.00 ","$18,303.53 "],["330104","","","","","","446","2","","","","Urethral & transurethral procedures","I","$0.00 ","$5,518.14 ","$0.00 ","$5,518.14 ","$0.00 ","$0.00 ","$0.00 ","$5,242.23 ","$0.00 ","$5,297.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,063.22 ","$5,518.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,683.68 ","$0.00 ","$0.00 ","$7,725.40 ","$21,129.95 ","$5,518.14 ","$7,449.49 ","$6,787.31 ","$0.00 ","$5,683.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,518.14 ","$14,533.36 ","$6,621.77 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","$22,824.42 ","$0.00 ","$0.00 ","$31,023.48 ","$88,276.76 ","$22,159.63 ","$29,915.50 ","$27,256.34 ","$0.00 ","$22,824.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,159.63 ","$60,717.51 ","$26,591.55 ","$22,159.63 ","$22,159.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,159.63 ","$22,159.63 ","$25,483.57 ","$22,159.63 ","$0.00 ","$0.00 ","$88,276.76 "],["330104","","","","","","470","1","","","","Chronic Kidney Disease #","I","$0.00 ","$3,453.78 ","$0.00 ","$3,453.78 ","$0.00 ","$0.00 ","$0.00 ","$3,281.09 ","$0.00 ","$3,315.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,420.83 ","$3,453.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,557.39 ","$0.00 ","$0.00 ","$4,835.29 ","$12,800.44 ","$3,453.78 ","$4,662.60 ","$4,248.14 ","$0.00 ","$3,557.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,453.78 ","$8,804.25 ","$4,144.53 ","$3,453.78 ","$3,453.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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","$9,166.95 ","$7,161.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,376.53 ","$0.00 ","$0.00 ","$10,026.35 ","$27,761.47 ","$7,161.68 ","$9,668.27 ","$8,808.86 ","$0.00 ","$7,376.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,161.68 ","$19,094.57 ","$8,594.01 ","$7,161.68 ","$7,161.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,161.68 ","$7,161.68 ","$8,235.93 ","$7,161.68 ","$0.00 ","$0.00 ","$27,761.47 "],["330104","","","","","","513","3","","","","Uterine & adnexa procedures for non-malignancy except leiomyoma","I","$0.00 ","$12,542.94 ","$0.00 ","$12,542.94 ","$0.00 ","$0.00 ","$0.00 ","$11,915.79 ","$0.00 ","$12,041.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,054.96 ","$12,542.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,919.23 ","$0.00 ","$0.00 ","$17,560.12 ","$49,474.35 ","$12,542.94 ","$16,932.97 ","$15,427.82 ","$0.00 ","$12,919.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,542.94 ","$34,028.88 ","$15,051.53 ","$12,542.94 ","$12,542.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,542.94 ","$12,542.94 ","$14,424.38 ","$12,542.94 ","$0.00 ","$0.00 ","$49,474.35 "],["330104","","","","","","513","4","","","","Uterine & adnexa procedures for non-malignancy except leiomyoma","I","$0.00 ","$32,102.37 ","$0.00 ","$32,102.37 ","$0.00 ","$0.00 ","$0.00 ","$30,497.25 ","$0.00 ","$30,818.27 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,091.03 ","$32,102.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,065.44 ","$0.00 ","$0.00 ","$44,943.32 ","$128,394.78 ","$32,102.37 ","$43,338.20 ","$39,485.91 ","$0.00 ","$33,065.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,102.37 ","$88,311.03 ","$38,522.84 ","$32,102.37 ","$32,102.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,102.37 ","$32,102.37 ","$36,917.72 ","$32,102.37 ","$0.00 ","$0.00 ","$128,394.78 "],["330104","","","","","","514","1","","","","Female reproductive system reconstructive procedures","I","$0.00 ","$6,870.08 ","$0.00 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$6,526.58 ","$0.00 ","$6,595.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,793.71 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$9,618.12 ","$26,584.91 ","$6,870.08 ","$9,274.61 ","$8,450.20 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$18,285.33 ","$8,244.10 ","$6,870.08 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$6,870.08 ","$7,900.59 ","$6,870.08 ","$0.00 ","$0.00 ","$26,584.91 "],["330104","","","","","","514","2","","","","Female reproductive system reconstructive procedures","I","$0.00 ","$6,870.08 ","$0.00 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$6,526.58 ","$0.00 ","$6,595.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,793.71 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$9,618.12 ","$26,584.91 ","$6,870.08 ","$9,274.61 ","$8,450.20 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$18,285.33 ","$8,244.10 ","$6,870.08 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$6,870.08 ","$7,900.59 ","$6,870.08 ","$0.00 ","$0.00 ","$26,584.91 "],["330104","","","","","","514","3","","","","Female reproductive system reconstructive procedures","I","$0.00 ","$6,870.08 ","$0.00 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$6,526.58 ","$0.00 ","$6,595.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,793.71 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$9,618.12 ","$26,584.91 ","$6,870.08 ","$9,274.61 ","$8,450.20 ","$0.00 ","$7,076.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$18,285.33 ","$8,244.10 ","$6,870.08 ","$6,870.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,870.08 ","$6,870.08 ","$7,900.59 ","$6,870.08 ","$0.00 ","$0.00 ","$26,584.91 "],["330104","","","","","","514","4","","","","Female reproductive system reconstructive procedures","I","$0.00 ","$20,991.92 ","$0.00 ","$20,991.92 ","$0.00 ","$0.00 ","$0.00 ","$19,942.32 ","$0.00 ","$20,152.24 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$26,869.66 ","$20,991.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,621.68 ","$0.00 ","$0.00 ","$29,388.69 ","$83,565.17 ","$20,991.92 ","$28,339.09 ","$25,820.06 ","$0.00 ","$21,621.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,991.92 ","$57,476.84 ","$25,190.30 ","$20,991.92 ","$20,991.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,991.92 ","$20,991.92 ","$24,140.71 ","$20,991.92 ","$0.00 ","$0.00 ","$83,565.17 "],["330104","","","","","","517","1","","","","Dilation & curettage for non-obstetric diagnoses","I","$0.00 ","$4,706.31 ","$0.00 ","$4,706.31 ","$0.00 ","$0.00 ","$0.00 ","$4,471.00 ","$0.00 ","$4,518.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,024.08 ","$4,706.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,847.50 ","$0.00 ","$0.00 ","$6,588.84 ","$17,854.30 ","$4,706.31 ","$6,353.52 ","$5,788.76 ","$0.00 ","$4,847.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,706.31 ","$12,280.34 ","$5,647.57 ","$4,706.31 ","$4,706.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,706.31 ","$4,706.31 ","$5,412.26 ","$4,706.31 ","$0.00 ","$0.00 ","$17,854.30 "],["330104","","","","","","517","2","","","","Dilation & curettage for non-obstetric diagnoses","I","$0.00 ","$6,474.44 ","$0.00 ","$6,474.44 ","$0.00 ","$0.00 ","$0.00 ","$6,150.72 ","$0.00 ","$6,215.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,287.28 ","$6,474.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,668.67 ","$0.00 ","$0.00 ","$9,064.22 ","$24,988.53 ","$6,474.44 ","$8,740.49 ","$7,963.56 ","$0.00 ","$6,668.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,474.44 ","$17,187.32 ","$7,769.33 ","$6,474.44 ","$6,474.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,474.44 ","$6,474.44 ","$7,445.61 ","$6,474.44 ","$0.00 ","$0.00 ","$24,988.53 "],["330104","","","","","","517","3","","","","Dilation & curettage for non-obstetric diagnoses","I","$0.00 ","$13,773.61 ","$0.00 ","$13,773.61 ","$0.00 ","$0.00 ","$0.00 ","$13,084.93 ","$0.00 ","$13,222.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,630.21 ","$13,773.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,186.81 ","$0.00 ","$0.00 ","$19,283.05 ","$54,439.97 ","$13,773.61 ","$18,594.37 ","$16,941.53 ","$0.00 ","$14,186.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,773.61 ","$37,444.27 ","$16,528.33 ","$13,773.61 ","$13,773.61 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,773.61 ","$13,773.61 ","$15,839.65 ","$13,773.61 ","$0.00 ","$0.00 ","$54,439.97 "],["330104","","","","","","517","4","","","","Dilation & curettage for non-obstetric diagnoses","I","$0.00 ","$14,529.10 ","$0.00 ","$14,529.10 ","$0.00 ","$0.00 ","$0.00 ","$13,802.65 ","$0.00 ","$13,947.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,597.25 ","$14,529.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,964.98 ","$0.00 ","$0.00 ","$20,340.74 ","$57,488.33 ","$14,529.10 ","$19,614.29 ","$17,870.80 ","$0.00 ","$14,964.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,529.10 ","$39,540.96 ","$17,434.92 ","$14,529.10 ","$14,529.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,529.10 ","$14,529.10 ","$16,708.47 ","$14,529.10 ","$0.00 ","$0.00 ","$57,488.33 "],["330104","","","","","","518","1","","","","Other female reproductive system & related procedures","I","$0.00 ","$5,290.83 ","$0.00 ","$5,290.83 ","$0.00 ","$0.00 ","$0.00 ","$5,026.29 ","$0.00 ","$5,079.19 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,772.26 ","$5,290.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,449.55 ","$0.00 ","$0.00 ","$7,407.16 ","$20,212.77 ","$5,290.83 ","$7,142.62 ","$6,507.72 ","$0.00 ","$5,449.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,290.83 ","$13,902.51 ","$6,348.99 ","$5,290.83 ","$5,290.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,290.83 ","$5,290.83 ","$6,084.45 ","$5,290.83 ","$0.00 ","$0.00 ","$20,212.77 "],["330104","","","","","","518","2","","","","Other female reproductive system & related procedures","I","$0.00 ","$7,455.26 ","$0.00 ","$7,455.26 ","$0.00 ","$0.00 ","$0.00 ","$7,082.50 ","$0.00 ","$7,157.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,542.73 ","$7,455.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,678.92 ","$0.00 ","$0.00 ","$10,437.37 ","$28,946.05 ","$7,455.26 ","$10,064.60 ","$9,169.97 ","$0.00 ","$7,678.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,455.26 ","$19,909.34 ","$8,946.31 ","$7,455.26 ","$7,455.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,455.26 ","$7,455.26 ","$8,573.55 ","$7,455.26 ","$0.00 ","$0.00 ","$28,946.05 "],["330104","","","","","","518","3","","","","Other female reproductive system & related procedures","I","$0.00 ","$14,323.00 ","$0.00 ","$14,323.00 ","$0.00 ","$0.00 ","$0.00 ","$13,606.85 ","$0.00 ","$13,750.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,333.44 ","$14,323.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,752.69 ","$0.00 ","$0.00 ","$20,052.20 ","$56,656.71 ","$14,323.00 ","$19,336.05 ","$17,617.29 ","$0.00 ","$14,752.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,323.00 ","$38,968.97 ","$17,187.60 ","$14,323.00 ","$14,323.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,323.00 ","$14,323.00 ","$16,471.45 ","$14,323.00 ","$0.00 ","$0.00 ","$56,656.71 "],["330104","","","","","","518","4","","","","Other female reproductive system & related procedures","I","$0.00 ","$39,897.91 ","$0.00 ","$39,897.91 ","$0.00 ","$0.00 ","$0.00 ","$37,903.01 ","$0.00 ","$38,301.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$51,069.32 ","$39,897.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,094.85 ","$0.00 ","$0.00 ","$55,857.07 ","$159,849.05 ","$39,897.91 ","$53,862.18 ","$49,074.43 ","$0.00 ","$41,094.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,897.91 ","$109,945.54 ","$47,877.49 ","$39,897.91 ","$39,897.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,897.91 ","$39,897.91 ","$45,882.60 ","$39,897.91 ","$0.00 ","$0.00 ","$159,849.05 "],["330104","","","","","","519","1","","","","Uterine & adnexa procedures for leiomyoma","I","$0.00 ","$5,972.76 ","$0.00 ","$5,972.76 ","$0.00 ","$0.00 ","$0.00 ","$5,674.13 ","$0.00 ","$5,733.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,645.14 ","$5,972.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,151.95 ","$0.00 ","$0.00 ","$8,361.87 ","$22,964.31 ","$5,972.76 ","$8,063.23 ","$7,346.50 ","$0.00 ","$6,151.95 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,972.76 ","$15,795.05 ","$7,167.32 ","$5,972.76 ","$5,972.76 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,972.76 ","$5,972.76 ","$6,868.68 ","$5,972.76 ","$0.00 ","$0.00 ","$22,964.31 "],["330104","","","","","","519","2","","","","Uterine & adnexa procedures for leiomyoma","I","$0.00 ","$7,406.22 ","$0.00 ","$7,406.22 ","$0.00 ","$0.00 ","$0.00 ","$7,035.91 ","$0.00 ","$7,109.97 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,479.96 ","$7,406.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,628.41 ","$0.00 ","$0.00 ","$10,368.71 ","$28,748.17 ","$7,406.22 ","$9,998.40 ","$9,109.65 ","$0.00 ","$7,628.41 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,406.22 ","$19,773.24 ","$8,887.46 ","$7,406.22 ","$7,406.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,406.22 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","$4,632.82 ","$3,860.68 ","$3,860.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,860.68 ","$3,860.68 ","$4,439.79 ","$3,860.68 ","$0.00 ","$0.00 ","$14,442.27 "],["330104","","","","","","640","4","","","","Neonate birthwt >2499g normal newborn or neonate w other problem","I","$0.00 ","$3,864.66 ","$0.00 ","$3,864.66 ","$0.00 ","$0.00 ","$0.00 ","$3,671.43 ","$0.00 ","$3,710.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,946.77 ","$3,864.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,980.60 ","$0.00 ","$0.00 ","$5,410.53 ","$14,458.32 ","$3,864.66 ","$5,217.29 ","$4,753.53 ","$0.00 ","$3,980.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,864.66 ","$9,944.55 ","$4,637.59 ","$3,864.66 ","$3,864.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,864.66 ","$3,864.66 ","$4,444.36 ","$3,864.66 ","$0.00 ","$0.00 ","$14,458.32 "],["330104","","","","","","650","1","","","","Splenectomy","I","$0.00 ","$8,892.03 ","$0.00 ","$8,892.03 ","$0.00 ","$0.00 ","$0.00 ","$8,447.43 ","$0.00 ","$8,536.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,381.80 ","$8,892.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,158.79 ","$0.00 ","$0.00 ","$12,448.84 ","$34,743.28 ","$8,892.03 ","$12,004.24 ","$10,937.20 ","$0.00 ","$9,158.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,892.03 ","$23,896.73 ","$10,670.44 ","$8,892.03 ","$8,892.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,892.03 ","$8,892.03 ","$10,225.84 ","$8,892.03 ","$0.00 ","$0.00 ","$34,743.28 "],["330104","","","","","","650","2","","","","Splenectomy","I","$0.00 ","$13,432.31 ","$0.00 ","$13,432.31 ","$0.00 ","$0.00 ","$0.00 ","$12,760.69 ","$0.00 ","$12,895.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,193.35 ","$13,432.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,835.28 ","$0.00 ","$0.00 ","$18,805.23 ","$53,062.86 ","$13,432.31 ","$18,133.61 ","$16,521.74 ","$0.00 ","$13,835.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,432.31 ","$36,497.08 ","$16,118.77 ","$13,432.31 ","$13,432.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,432.31 ","$13,432.31 ","$15,447.15 ","$13,432.31 ","$0.00 ","$0.00 ","$53,062.86 "],["330104","","","","","","650","3","","","","Splenectomy","I","$0.00 ","$16,128.90 ","$0.00 ","$16,128.90 ","$0.00 ","$0.00 ","$0.00 ","$15,322.46 ","$0.00 ","$15,483.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,644.99 ","$16,128.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,612.77 ","$0.00 ","$0.00 ","$22,580.46 ","$63,943.36 ","$16,128.90 ","$21,774.02 ","$19,838.55 ","$0.00 ","$16,612.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,128.90 ","$43,980.79 ","$19,354.68 ","$16,128.90 ","$16,128.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,128.90 ","$16,128.90 ","$18,548.24 ","$16,128.90 ","$0.00 ","$0.00 ","$63,943.36 "],["330104","","","","","","650","4","","","","Splenectomy","I","$0.00 ","$38,076.10 ","$0.00 ","$38,076.10 ","$0.00 ","$0.00 ","$0.00 ","$36,172.30 ","$0.00 ","$36,553.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$48,737.41 ","$38,076.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,218.38 ","$0.00 ","$0.00 ","$53,306.54 ","$152,498.22 ","$38,076.10 ","$51,402.74 ","$46,833.60 ","$0.00 ","$39,218.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,076.10 ","$104,889.58 ","$45,691.32 ","$38,076.10 ","$38,076.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$38,076.10 ","$38,076.10 ","$43,787.52 ","$38,076.10 ","$0.00 ","$0.00 ","$152,498.22 "],["330104","","","","","","651","1","","","","Other procedures of blood & blood-forming organs","I","$0.00 ","$7,182.22 ","$0.00 ","$7,182.22 ","$0.00 ","$0.00 ","$0.00 ","$6,823.11 ","$0.00 ","$6,894.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,193.24 ","$7,182.22 ","$0.00 ","$0.00 ","$0.00 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","$0.00 ","$0.00 ","$0.00 ","$24,014.45 ","$0.00 ","$24,267.24 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,356.32 ","$25,278.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$26,036.72 ","$0.00 ","$0.00 ","$35,389.72 ","$100,860.61 ","$25,278.37 ","$34,125.80 ","$31,092.40 ","$0.00 ","$26,036.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,278.37 ","$69,372.78 ","$30,334.05 ","$25,278.37 ","$25,278.37 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,278.37 ","$25,278.37 ","$29,070.13 ","$25,278.37 ","$0.00 ","$0.00 ","$100,860.61 "],["330104","","","","","","660","1","","","","Major hematologic\/immunologic diag exc sickle cell crisis & coagul","I","$0.00 ","$4,902.48 ","$0.00 ","$4,902.48 ","$0.00 ","$0.00 ","$0.00 ","$4,657.35 ","$0.00 ","$4,706.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,275.17 ","$4,902.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,049.55 ","$0.00 ","$0.00 ","$6,863.47 ","$18,645.80 ","$4,902.48 ","$6,618.34 ","$6,030.05 ","$0.00 ","$5,049.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,902.48 ","$12,824.74 ","$5,882.97 ","$4,902.48 ","$4,902.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,902.48 ","$4,902.48 ","$5,637.85 ","$4,902.48 ","$0.00 ","$0.00 ","$18,645.80 "],["330104","","","","","","660","2","","","","Major hematologic\/immunologic diag exc sickle cell crisis & coagul","I","$0.00 ","$6,245.14 ","$0.00 ","$6,245.14 ","$0.00 ","$0.00 ","$0.00 ","$5,932.88 ","$0.00 ","$5,995.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,993.78 ","$6,245.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,432.49 ","$0.00 ","$0.00 ","$8,743.20 ","$24,063.33 ","$6,245.14 ","$8,430.94 ","$7,681.52 ","$0.00 ","$6,432.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,245.14 ","$16,550.96 ","$7,494.17 ","$6,245.14 ","$6,245.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,245.14 ","$6,245.14 ","$7,181.91 ","$6,245.14 ","$0.00 ","$0.00 ","$24,063.33 "],["330104","","","","","","660","3","","","","Major hematologic\/immunologic diag exc sickle cell crisis & coagul","I","$0.00 ","$10,365.91 ","$0.00 ","$10,365.91 ","$0.00 ","$0.00 ","$0.00 ","$9,847.62 ","$0.00 ","$9,951.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,268.37 ","$10,365.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,676.89 ","$0.00 ","$0.00 ","$14,512.28 ","$40,690.26 ","$10,365.91 ","$13,993.98 ","$12,750.07 ","$0.00 ","$10,676.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,365.91 ","$27,987.11 ","$12,439.10 ","$10,365.91 ","$10,365.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,365.91 ","$10,365.91 ","$11,920.80 ","$10,365.91 ","$0.00 ","$0.00 ","$40,690.26 "],["330104","","","","","","660","4","","","","Major hematologic\/immunologic diag exc sickle cell crisis & coagul","I","$0.00 ","$33,271.40 ","$0.00 ","$33,271.40 ","$0.00 ","$0.00 ","$0.00 ","$31,607.83 ","$0.00 ","$31,940.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,587.39 ","$33,271.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$34,269.54 ","$0.00 ","$0.00 ","$46,579.96 ","$133,111.72 ","$33,271.40 ","$44,916.39 ","$40,923.82 ","$0.00 ","$34,269.54 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,271.40 ","$91,555.38 ","$39,925.68 ","$33,271.40 ","$33,271.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,271.40 ","$33,271.40 ","$38,262.11 ","$33,271.40 ","$0.00 ","$0.00 ","$133,111.72 "],["330104","","","","","","661","1","","","","Coagulation & platelet disorders","I","$0.00 ","$6,972.14 ","$0.00 ","$6,972.14 ","$0.00 ","$0.00 ","$0.00 ","$6,623.53 ","$0.00 ","$6,693.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,924.34 ","$6,972.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,181.31 ","$0.00 ","$0.00 ","$9,761.00 ","$26,996.70 ","$6,972.14 ","$9,412.39 ","$8,575.73 ","$0.00 ","$7,181.31 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,972.14 ","$18,568.56 ","$8,366.57 ","$6,972.14 ","$6,972.14 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,972.14 ","$6,972.14 ","$8,017.96 ","$6,972.14 ","$0.00 ","$0.00 ","$26,996.70 "],["330104","","","","","","661","2","","","","Coagulation & platelet disorders","I","$0.00 ","$8,139.85 ","$0.00 ","$8,139.85 ","$0.00 ","$0.00 ","$0.00 ","$7,732.86 ","$0.00 ","$7,814.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,419.01 ","$8,139.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,384.04 ","$0.00 ","$0.00 ","$11,395.79 ","$31,708.29 ","$8,139.85 ","$10,988.80 ","$10,012.01 ","$0.00 ","$8,384.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,139.85 ","$21,809.23 ","$9,767.82 ","$8,139.85 ","$8,139.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,139.85 ","$8,139.85 ","$9,360.83 ","$8,139.85 ","$0.00 ","$0.00 ","$31,708.29 "],["330104","","","","","","661","3","","","","Coagulation & platelet disorders","I","$0.00 ","$13,242.77 ","$0.00 ","$13,242.77 ","$0.00 ","$0.00 ","$0.00 ","$12,580.63 ","$0.00 ","$12,713.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,950.74 ","$13,242.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,640.05 ","$0.00 ","$0.00 ","$18,539.88 ","$52,298.09 ","$13,242.77 ","$17,877.74 ","$16,288.61 ","$0.00 ","$13,640.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,242.77 ","$35,971.07 ","$15,891.32 ","$13,242.77 ","$13,242.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,242.77 ","$13,242.77 ","$15,229.18 ","$13,242.77 ","$0.00 ","$0.00 ","$52,298.09 "],["330104","","","","","","661","4","","","","Coagulation & platelet disorders","I","$0.00 ","$30,541.67 ","$0.00 ","$30,541.67 ","$0.00 ","$0.00 ","$0.00 ","$29,014.59 ","$0.00 ","$29,320.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$39,093.34 ","$30,541.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$31,457.92 ","$0.00 ","$0.00 ","$42,758.34 ","$122,097.51 ","$30,541.67 ","$41,231.26 ","$37,566.26 ","$0.00 ","$31,457.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,541.67 ","$83,979.71 ","$36,650.01 ","$30,541.67 ","$30,541.67 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,541.67 ","$30,541.67 ","$35,122.92 ","$30,541.67 ","$0.00 ","$0.00 ","$122,097.51 "],["330104","","","","","","662","1","","","","Sickle cell anemia crisis","I","$0.00 ","$4,713.60 ","$0.00 ","$4,713.60 ","$0.00 ","$0.00 ","$0.00 ","$4,477.92 ","$0.00 ","$4,525.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,033.41 ","$4,713.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,855.01 ","$0.00 ","$0.00 ","$6,599.04 ","$17,883.71 ","$4,713.60 ","$6,363.36 ","$5,797.73 ","$0.00 ","$4,855.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,713.60 ","$12,300.57 ","$5,656.32 ","$4,713.60 ","$4,713.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,713.60 ","$4,713.60 ","$5,420.64 ","$4,713.60 ","$0.00 ","$0.00 ","$17,883.71 "],["330104","","","","","","662","2","","","","Sickle cell anemia crisis","I","$0.00 ","$6,677.89 ","$0.00 ","$6,677.89 ","$0.00 ","$0.00 ","$0.00 ","$6,344.00 ","$0.00 ","$6,410.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,547.70 ","$6,677.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,878.23 ","$0.00 ","$0.00 ","$9,349.05 ","$25,809.45 ","$6,677.89 ","$9,015.16 ","$8,213.81 ","$0.00 ","$6,878.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,677.89 ","$17,751.96 ","$8,013.47 ","$6,677.89 ","$6,677.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,677.89 ","$6,677.89 ","$7,679.58 ","$6,677.89 ","$0.00 ","$0.00 ","$25,809.45 "],["330104","","","","","","662","3","","","","Sickle cell anemia crisis","I","$0.00 ","$10,491.83 ","$0.00 ","$10,491.83 ","$0.00 ","$0.00 ","$0.00 ","$9,967.24 ","$0.00 ","$10,072.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,429.54 ","$10,491.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,806.59 ","$0.00 ","$0.00 ","$14,688.56 ","$41,198.32 ","$10,491.83 ","$14,163.97 ","$12,904.95 ","$0.00 ","$10,806.59 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,491.83 ","$28,336.55 ","$12,590.20 ","$10,491.83 ","$10,491.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,491.83 ","$10,491.83 ","$12,065.61 ","$10,491.83 ","$0.00 ","$0.00 ","$41,198.32 "],["330104","","","","","","662","4","","","","Sickle cell anemia crisis","I","$0.00 ","$22,232.53 ","$0.00 ","$22,232.53 ","$0.00 ","$0.00 ","$0.00 ","$21,120.90 ","$0.00 ","$21,343.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$28,457.63 ","$22,232.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,899.50 ","$0.00 ","$0.00 ","$31,125.54 ","$88,570.90 ","$22,232.53 ","$30,013.91 ","$27,346.01 ","$0.00 ","$22,899.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,232.53 ","$60,919.82 ","$26,679.03 ","$22,232.53 ","$22,232.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,232.53 ","$22,232.53 ","$25,567.40 ","$22,232.53 ","$0.00 ","$0.00 ","$88,570.90 "],["330104","","","","","","663","1","","","","Other anemia & disorders of blood & blood-forming organs","I","$0.00 ","$3,683.08 ","$0.00 ","$3,683.08 ","$0.00 ","$0.00 ","$0.00 ","$3,498.92 ","$0.00 ","$3,535.75 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,714.34 ","$3,683.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,793.57 ","$0.00 ","$0.00 ","$5,156.31 ","$13,725.64 ","$3,683.08 ","$4,972.15 ","$4,530.18 ","$0.00 ","$3,793.57 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,683.08 ","$9,440.61 ","$4,419.69 ","$3,683.08 ","$3,683.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$3,683.08 ","$3,683.08 ","$4,235.54 ","$3,683.08 ","$0.00 ","$0.00 ","$13,725.64 "],["330104","","","","","","663","2","","","","Other anemia & disorders of blood & blood-forming organs","I","$0.00 ","$4,950.85 ","$0.00 ","$4,950.85 ","$0.00 ","$0.00 ","$0.00 ","$4,703.31 ","$0.00 ","$4,752.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,337.09 ","$4,950.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,099.38 ","$0.00 ","$0.00 ","$6,931.20 ","$18,841.00 ","$4,950.85 ","$6,683.65 ","$6,089.55 ","$0.00 ","$5,099.38 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,950.85 ","$12,959.00 ","$5,941.02 ","$4,950.85 ","$4,950.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,950.85 ","$4,950.85 ","$5,693.48 ","$4,950.85 ","$0.00 ","$0.00 ","$18,841.00 "],["330104","","","","","","663","3","","","","Other anemia & disorders of blood & blood-forming organs","I","$0.00 ","$7,640.16 ","$0.00 ","$7,640.16 ","$0.00 ","$0.00 ","$0.00 ","$7,258.15 ","$0.00 ","$7,334.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,779.40 ","$7,640.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,869.36 ","$0.00 ","$0.00 ","$10,696.22 ","$29,692.10 ","$7,640.16 ","$10,314.22 ","$9,397.40 ","$0.00 ","$7,869.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,640.16 ","$20,422.48 ","$9,168.19 ","$7,640.16 ","$7,640.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,640.16 ","$7,640.16 ","$8,786.18 ","$7,640.16 ","$0.00 ","$0.00 ","$29,692.10 "],["330104","","","","","","663","4","","","","Other anemia & disorders of blood & blood-forming organs","I","$0.00 ","$15,890.99 ","$0.00 ","$15,890.99 ","$0.00 ","$0.00 ","$0.00 ","$15,096.44 ","$0.00 ","$15,255.35 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,340.46 ","$15,890.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,367.72 ","$0.00 ","$0.00 ","$22,247.38 ","$62,983.40 ","$15,890.99 ","$21,452.83 ","$19,545.91 ","$0.00 ","$16,367.72 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,890.99 ","$43,320.52 ","$19,069.18 ","$15,890.99 ","$15,890.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,890.99 ","$15,890.99 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","$0.00 ","$14,150.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,867.00 ","$14,739.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,182.04 ","$0.00 ","$0.00 ","$20,635.79 ","$58,338.66 ","$14,739.85 ","$19,898.79 ","$18,130.01 ","$0.00 ","$15,182.04 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,739.85 ","$40,125.83 ","$17,687.82 ","$14,739.85 ","$14,739.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,739.85 ","$14,739.85 ","$16,950.82 ","$14,739.85 ","$0.00 ","$0.00 ","$58,338.66 "],["330104","","","","","","680","3","","","","Major O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$25,919.88 ","$0.00 ","$25,919.88 ","$0.00 ","$0.00 ","$0.00 ","$24,623.89 ","$0.00 ","$24,883.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$33,177.45 ","$25,919.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$26,697.48 ","$0.00 ","$0.00 ","$36,287.84 ","$103,449.04 ","$25,919.88 ","$34,991.84 ","$31,881.46 ","$0.00 ","$26,697.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,919.88 ","$71,153.13 ","$31,103.86 ","$25,919.88 ","$25,919.88 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,919.88 ","$25,919.88 ","$29,807.86 ","$25,919.88 ","$0.00 ","$0.00 ","$103,449.04 "],["330104","","","","","","680","4","","","","Major O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$59,570.00 ","$0.00 ","$59,570.00 ","$0.00 ","$0.00 ","$0.00 ","$56,591.50 ","$0.00 ","$57,187.20 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$76,249.60 ","$59,570.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$61,357.10 ","$0.00 ","$0.00 ","$83,398.00 ","$239,224.06 ","$59,570.00 ","$80,419.50 ","$73,271.10 ","$0.00 ","$61,357.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,570.00 ","$164,540.35 ","$71,484.00 ","$59,570.00 ","$59,570.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,570.00 ","$59,570.00 ","$68,505.50 ","$59,570.00 ","$0.00 ","$0.00 ","$239,224.06 "],["330104","","","","","","681","1","","","","Other O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$6,565.23 ","$0.00 ","$6,565.23 ","$0.00 ","$0.00 ","$0.00 ","$6,236.97 ","$0.00 ","$6,302.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,403.50 ","$6,565.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,762.19 ","$0.00 ","$0.00 ","$9,191.33 ","$25,354.87 ","$6,565.23 ","$8,863.06 ","$8,075.24 ","$0.00 ","$6,762.19 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,565.23 ","$17,439.29 ","$7,878.28 ","$6,565.23 ","$6,565.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,565.23 ","$6,565.23 ","$7,550.02 ","$6,565.23 ","$0.00 ","$0.00 ","$25,354.87 "],["330104","","","","","","681","2","","","","Other O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$10,788.73 ","$0.00 ","$10,788.73 ","$0.00 ","$0.00 ","$0.00 ","$10,249.29 ","$0.00 ","$10,357.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,809.57 ","$10,788.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,112.39 ","$0.00 ","$0.00 ","$15,104.22 ","$42,396.27 ","$10,788.73 ","$14,564.78 ","$13,270.14 ","$0.00 ","$11,112.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,788.73 ","$29,160.52 ","$12,946.47 ","$10,788.73 ","$10,788.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,788.73 ","$10,788.73 ","$12,407.04 ","$10,788.73 ","$0.00 ","$0.00 ","$42,396.27 "],["330104","","","","","","681","3","","","","Other O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$25,592.50 ","$0.00 ","$25,592.50 ","$0.00 ","$0.00 ","$0.00 ","$24,312.88 ","$0.00 ","$24,568.80 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$32,758.40 ","$25,592.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$26,360.28 ","$0.00 ","$0.00 ","$35,829.50 ","$102,128.08 ","$25,592.50 ","$34,549.88 ","$31,478.78 ","$0.00 ","$26,360.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,592.50 ","$70,244.57 ","$30,711.00 ","$25,592.50 ","$25,592.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$25,592.50 ","$25,592.50 ","$29,431.38 ","$25,592.50 ","$0.00 ","$0.00 ","$102,128.08 "],["330104","","","","","","681","4","","","","Other O.R. procedures for lymphatic\/hematopoietic\/other neoplasms","I","$0.00 ","$59,735.02 ","$0.00 ","$59,735.02 ","$0.00 ","$0.00 ","$0.00 ","$56,748.27 ","$0.00 ","$57,345.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$76,460.82 ","$59,735.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$61,527.07 ","$0.00 ","$0.00 ","$83,629.02 ","$239,889.89 ","$59,735.02 ","$80,642.27 ","$73,474.07 ","$0.00 ","$61,527.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,735.02 ","$164,998.31 ","$71,682.02 ","$59,735.02 ","$59,735.02 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$59,735.02 ","$59,735.02 ","$68,695.27 ","$59,735.02 ","$0.00 ","$0.00 ","$239,889.89 "],["330104","","","","","","690","1","","","","Acute leukemia","I","$0.00 ","$9,139.89 ","$0.00 ","$9,139.89 ","$0.00 ","$0.00 ","$0.00 ","$8,682.89 ","$0.00 ","$8,774.29 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,699.06 ","$9,139.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,414.08 ","$0.00 ","$0.00 ","$12,795.84 ","$35,743.36 ","$9,139.89 ","$12,338.85 ","$11,242.06 ","$0.00 ","$9,414.08 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,139.89 ","$24,584.59 ","$10,967.87 ","$9,139.89 ","$9,139.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,139.89 ","$9,139.89 ","$10,510.87 ","$9,139.89 ","$0.00 ","$0.00 ","$35,743.36 "],["330104","","","","","","690","2","","","","Acute leukemia","I","$0.00 ","$18,298.64 ","$0.00 ","$18,298.64 ","$0.00 ","$0.00 ","$0.00 ","$17,383.71 ","$0.00 ","$17,566.69 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,422.26 ","$18,298.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,847.60 ","$0.00 ","$0.00 ","$25,618.09 ","$72,698.04 ","$18,298.64 ","$24,703.16 ","$22,507.32 ","$0.00 ","$18,847.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,298.64 ","$50,002.33 ","$21,958.36 ","$18,298.64 ","$18,298.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,298.64 ","$18,298.64 ","$21,043.43 ","$18,298.64 ","$0.00 ","$0.00 ","$72,698.04 "],["330104","","","","","","690","3","","","","Acute leukemia","I","$0.00 ","$40,461.22 ","$0.00 ","$40,461.22 ","$0.00 ","$0.00 ","$0.00 ","$38,438.16 ","$0.00 ","$38,842.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$51,790.36 ","$40,461.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$41,675.06 ","$0.00 ","$0.00 ","$56,645.71 ","$162,121.95 ","$40,461.22 ","$54,622.65 ","$49,767.30 ","$0.00 ","$41,675.06 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$40,461.22 ","$111,508.86 ","$48,553.46 ","$40,461.22 ","$40,461.22 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$40,461.22 ","$40,461.22 ","$46,530.40 ","$40,461.22 ","$0.00 ","$0.00 ","$162,121.95 "],["330104","","","","","","690","4","","","","Acute leukemia","I","$0.00 ","$58,289.63 ","$0.00 ","$58,289.63 ","$0.00 ","$0.00 ","$0.00 ","$55,375.15 ","$0.00 ","$55,958.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$74,610.73 ","$58,289.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$60,038.32 ","$0.00 ","$0.00 ","$81,605.48 ","$234,057.89 ","$58,289.63 ","$78,691.00 ","$71,696.25 ","$0.00 ","$60,038.32 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$58,289.63 ","$160,987.02 ","$69,947.56 ","$58,289.63 ","$58,289.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$58,289.63 ","$58,289.63 ","$67,033.08 ","$58,289.63 ","$0.00 ","$0.00 ","$234,057.89 "],["330104","","","","","","691","1","","","","Lymphoma myeloma & non-acute leukemia","I","$0.00 ","$7,058.96 ","$0.00 ","$7,058.96 ","$0.00 ","$0.00 ","$0.00 ","$6,706.01 ","$0.00 ","$6,776.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,035.46 ","$7,058.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,270.73 ","$0.00 ","$0.00 ","$9,882.54 ","$27,347.00 ","$7,058.96 ","$9,529.59 ","$8,682.52 ","$0.00 ","$7,270.73 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,058.96 ","$18,809.50 ","$8,470.75 ","$7,058.96 ","$7,058.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,058.96 ","$7,058.96 ","$8,117.80 ","$7,058.96 ","$0.00 ","$0.00 ","$27,347.00 "],["330104","","","","","","691","2","","","","Lymphoma myeloma & non-acute leukemia","I","$0.00 ","$10,116.07 ","$0.00 ","$10,116.07 ","$0.00 ","$0.00 ","$0.00 ","$9,610.27 ","$0.00 ","$9,711.43 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,948.57 ","$10,116.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,419.55 ","$0.00 ","$0.00 ","$14,162.50 ","$39,682.16 ","$10,116.07 ","$13,656.69 ","$12,442.77 ","$0.00 ","$10,419.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,116.07 ","$27,293.73 ","$12,139.28 ","$10,116.07 ","$10,116.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,116.07 ","$10,116.07 ","$11,633.48 ","$10,116.07 ","$0.00 ","$0.00 ","$39,682.16 "],["330104","","","","","","691","3","","","","Lymphoma myeloma & non-acute leukemia","I","$0.00 ","$16,933.44 ","$0.00 ","$16,933.44 ","$0.00 ","$0.00 ","$0.00 ","$16,086.77 ","$0.00 ","$16,256.10 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,674.80 ","$16,933.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$17,441.44 ","$0.00 ","$0.00 ","$23,706.82 ","$67,189.60 ","$16,933.44 ","$22,860.14 ","$20,828.13 ","$0.00 ","$17,441.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,933.44 ","$46,213.58 ","$20,320.13 ","$16,933.44 ","$16,933.44 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,933.44 ","$16,933.44 ","$19,473.46 ","$16,933.44 ","$0.00 ","$0.00 ","$67,189.60 "],["330104","","","","","","691","4","","","","Lymphoma myeloma & non-acute leukemia","I","$0.00 ","$42,249.89 ","$0.00 ","$42,249.89 ","$0.00 ","$0.00 ","$0.00 ","$40,137.40 ","$0.00 ","$40,559.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$54,079.86 ","$42,249.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$43,517.39 ","$0.00 ","$0.00 ","$59,149.85 ","$169,339.07 ","$42,249.89 ","$57,037.35 ","$51,967.37 ","$0.00 ","$43,517.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,249.89 ","$116,472.86 ","$50,699.87 ","$42,249.89 ","$42,249.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$42,249.89 ","$42,249.89 ","$48,587.38 ","$42,249.89 ","$0.00 ","$0.00 ","$169,339.07 "],["330104","","","","","","692","1","","","","Radiotherapy","I","$0.00 ","$4,230.48 ","$0.00 ","$4,230.48 ","$0.00 ","$0.00 ","$0.00 ","$4,018.96 ","$0.00 ","$4,061.26 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,415.02 ","$4,230.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,357.40 ","$0.00 ","$0.00 ","$5,922.67 ","$15,934.37 ","$4,230.48 ","$5,711.15 ","$5,203.49 ","$0.00 ","$4,357.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,230.48 ","$10,959.79 ","$5,076.58 ","$4,230.48 ","$4,230.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,230.48 ","$4,230.48 ","$4,865.05 ","$4,230.48 ","$0.00 ","$0.00 ","$15,934.37 "],["330104","","","","","","692","2","","","","Radiotherapy","I","$0.00 ","$8,902.64 ","$0.00 ","$8,902.64 ","$0.00 ","$0.00 ","$0.00 ","$8,457.50 ","$0.00 ","$8,546.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,395.37 ","$8,902.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,169.71 ","$0.00 ","$0.00 ","$12,463.69 ","$34,786.07 ","$8,902.64 ","$12,018.56 ","$10,950.24 ","$0.00 ","$9,169.71 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,902.64 ","$23,926.15 ","$10,683.16 ","$8,902.64 ","$8,902.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,902.64 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","$20,982.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,612.12 ","$0.00 ","$0.00 ","$29,375.70 ","$83,527.74 ","$20,982.64 ","$28,326.57 ","$25,808.65 ","$0.00 ","$21,612.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,982.64 ","$57,451.09 ","$25,179.17 ","$20,982.64 ","$20,982.64 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$20,982.64 ","$20,982.64 ","$24,130.04 ","$20,982.64 ","$0.00 ","$0.00 ","$83,527.74 "],["330104","","","","","","694","1","","","","Lymphatic & other malignancies & neoplasms of uncertain behavior","I","$0.00 ","$4,408.09 ","$0.00 ","$4,408.09 ","$0.00 ","$0.00 ","$0.00 ","$4,187.68 ","$0.00 ","$4,231.77 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,642.35 ","$4,408.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,540.33 ","$0.00 ","$0.00 ","$6,171.32 ","$16,651.00 ","$4,408.09 ","$5,950.92 ","$5,421.95 ","$0.00 ","$4,540.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,408.09 ","$11,452.70 ","$5,289.71 ","$4,408.09 ","$4,408.09 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,408.09 ","$4,408.09 ","$5,069.30 ","$4,408.09 ","$0.00 ","$0.00 ","$16,651.00 "],["330104","","","","","","694","2","","","","Lymphatic & other malignancies & neoplasms of uncertain behavior","I","$0.00 ","$6,785.92 ","$0.00 ","$6,785.92 ","$0.00 ","$0.00 ","$0.00 ","$6,446.62 ","$0.00 ","$6,514.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,685.97 ","$6,785.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,989.49 ","$0.00 ","$0.00 ","$9,500.28 ","$26,245.31 ","$6,785.92 ","$9,160.99 ","$8,346.68 ","$0.00 ","$6,989.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,785.92 ","$18,051.75 ","$8,143.10 ","$6,785.92 ","$6,785.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,785.92 ","$6,785.92 ","$7,803.80 ","$6,785.92 ","$0.00 ","$0.00 ","$26,245.31 "],["330104","","","","","","694","3","","","","Lymphatic & other malignancies & neoplasms of uncertain behavior","I","$0.00 ","$11,023.33 ","$0.00 ","$11,023.33 ","$0.00 ","$0.00 ","$0.00 ","$10,472.16 ","$0.00 ","$10,582.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,109.86 ","$11,023.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,354.03 ","$0.00 ","$0.00 ","$15,432.66 ","$43,342.87 ","$11,023.33 ","$14,881.50 ","$13,558.70 ","$0.00 ","$11,354.03 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,023.33 ","$29,811.59 ","$13,228.00 ","$11,023.33 ","$11,023.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$11,023.33 ","$11,023.33 ","$12,676.83 ","$11,023.33 ","$0.00 ","$0.00 ","$43,342.87 "],["330104","","","","","","694","4","","","","Lymphatic & other malignancies & neoplasms of uncertain behavior","I","$0.00 ","$22,690.46 ","$0.00 ","$22,690.46 ","$0.00 ","$0.00 ","$0.00 ","$21,555.94 ","$0.00 ","$21,782.84 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$29,043.79 ","$22,690.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$23,371.18 ","$0.00 ","$0.00 ","$31,766.65 ","$90,418.64 ","$22,690.46 ","$30,632.12 ","$27,909.27 ","$0.00 ","$23,371.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,690.46 ","$62,190.71 ","$27,228.56 ","$22,690.46 ","$22,690.46 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,690.46 ","$22,690.46 ","$26,094.03 ","$22,690.46 ","$0.00 ","$0.00 ","$90,418.64 "],["330104","","","","","","695","1","","","","Chemotherapy for acute leukemia #","I","$0.00 ","$6,278.28 ","$0.00 ","$6,278.28 ","$0.00 ","$0.00 ","$0.00 ","$5,964.36 ","$0.00 ","$6,027.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,036.19 ","$6,278.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,466.62 ","$0.00 ","$0.00 ","$8,789.59 ","$24,197.03 ","$6,278.28 ","$8,475.67 ","$7,722.28 ","$0.00 ","$6,466.62 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,278.28 ","$16,642.92 ","$7,533.93 ","$6,278.28 ","$6,278.28 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,278.28 ","$6,278.28 ","$7,220.02 ","$6,278.28 ","$0.00 ","$0.00 ","$24,197.03 "],["330104","","","","","","695","2","","","","Chemotherapy for acute leukemia #","I","$0.00 ","$6,286.89 ","$0.00 ","$6,286.89 ","$0.00 ","$0.00 ","$0.00 ","$5,972.55 ","$0.00 ","$6,035.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,047.22 ","$6,286.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,475.50 ","$0.00 ","$0.00 ","$8,801.65 ","$24,231.79 ","$6,286.89 ","$8,487.30 ","$7,732.88 ","$0.00 ","$6,475.50 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,286.89 ","$16,666.83 ","$7,544.27 ","$6,286.89 ","$6,286.89 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,286.89 ","$6,286.89 ","$7,229.93 ","$6,286.89 ","$0.00 ","$0.00 ","$24,231.79 "],["330104","","","","","","695","3","","","","Chemotherapy for acute leukemia #","I","$0.00 ","$16,438.39 ","$0.00 ","$16,438.39 ","$0.00 ","$0.00 ","$0.00 ","$15,616.47 ","$0.00 ","$15,780.85 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,041.14 ","$16,438.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,931.54 ","$0.00 ","$0.00 ","$23,013.75 ","$65,192.12 ","$16,438.39 ","$22,191.83 ","$20,219.22 ","$0.00 ","$16,931.54 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,438.39 ","$44,839.70 ","$19,726.07 ","$16,438.39 ","$16,438.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$16,438.39 ","$16,438.39 ","$18,904.15 ","$16,438.39 ","$0.00 ","$0.00 ","$65,192.12 "],["330104","","","","","","695","4","","","","Chemotherapy for acute leukemia #","I","$0.00 ","$49,234.93 ","$0.00 ","$49,234.93 ","$0.00 ","$0.00 ","$0.00 ","$46,773.18 ","$0.00 ","$47,265.53 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$63,020.71 ","$49,234.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$50,711.98 ","$0.00 ","$0.00 ","$68,928.90 ","$197,523.03 ","$49,234.93 ","$66,467.15 ","$60,558.96 ","$0.00 ","$50,711.98 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,234.93 ","$135,858.03 ","$59,081.92 ","$49,234.93 ","$49,234.93 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$49,234.93 ","$49,234.93 ","$56,620.17 ","$49,234.93 ","$0.00 ","$0.00 ","$197,523.03 "],["330104","","","","","","696","1","","","","Other Chemotherapy #","I","$0.00 ","$5,231.18 ","$0.00 ","$5,231.18 ","$0.00 ","$0.00 ","$0.00 ","$4,969.62 ","$0.00 ","$5,021.94 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,695.91 ","$5,231.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,388.12 ","$0.00 ","$0.00 ","$7,323.66 ","$19,972.11 ","$5,231.18 ","$7,062.10 ","$6,434.36 ","$0.00 ","$5,388.12 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,231.18 ","$13,736.98 ","$6,277.42 ","$5,231.18 ","$5,231.18 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,231.18 ","$5,231.18 ","$6,015.86 ","$5,231.18 ","$0.00 ","$0.00 ","$19,972.11 "],["330104","","","","","","696","2","","","","Other Chemotherapy #","I","$0.00 ","$6,937.68 ","$0.00 ","$6,937.68 ","$0.00 ","$0.00 ","$0.00 ","$6,590.80 ","$0.00 ","$6,660.17 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,880.23 ","$6,937.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,145.81 ","$0.00 ","$0.00 ","$9,712.75 ","$26,857.66 ","$6,937.68 ","$9,365.87 ","$8,533.35 ","$0.00 ","$7,145.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,937.68 ","$18,472.92 ","$8,325.22 ","$6,937.68 ","$6,937.68 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,937.68 ","$6,937.68 ","$7,978.33 ","$6,937.68 ","$0.00 ","$0.00 ","$26,857.66 "],["330104","","","","","","696","3","","","","Other Chemotherapy #","I","$0.00 ","$10,321.51 ","$0.00 ","$10,321.51 ","$0.00 ","$0.00 ","$0.00 ","$9,805.44 ","$0.00 ","$9,908.65 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$13,211.54 ","$10,321.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,631.16 ","$0.00 ","$0.00 ","$14,450.12 ","$40,511.10 ","$10,321.51 ","$13,934.04 ","$12,695.46 ","$0.00 ","$10,631.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,321.51 ","$27,863.88 ","$12,385.82 ","$10,321.51 ","$10,321.51 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,321.51 ","$10,321.51 ","$11,869.74 ","$10,321.51 ","$0.00 ","$0.00 ","$40,511.10 "],["330104","","","","","","696","4","","","","Other Chemotherapy #","I","$0.00 ","$29,403.79 ","$0.00 ","$29,403.79 ","$0.00 ","$0.00 ","$0.00 ","$27,933.60 ","$0.00 ","$28,227.63 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$37,636.85 ","$29,403.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$30,285.90 ","$0.00 ","$0.00 ","$41,165.30 ","$117,506.26 ","$29,403.79 ","$39,695.11 ","$36,166.66 ","$0.00 ","$30,285.90 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$29,403.79 ","$80,821.80 ","$35,284.54 ","$29,403.79 ","$29,403.79 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$29,403.79 ","$29,403.79 ","$33,814.35 ","$29,403.79 ","$0.00 ","$0.00 ","$117,506.26 "],["330104","","","","","","710","1","","","","Infectious & parasitic diseases including HIV w O.R. procedure","I","$0.00 ","$7,464.54 ","$0.00 ","$7,464.54 ","$0.00 ","$0.00 ","$0.00 ","$7,091.31 ","$0.00 ","$7,165.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,554.61 ","$7,464.54 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,688.48 ","$0.00 ","$0.00 ","$10,450.36 ","$28,983.49 ","$7,464.54 ","$10,077.13 ","$9,181.38 ","$0.00 ","$7,688.48 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,464.54 ","$19,935.09 ","$8,957.45 ","$7,464.54 ","$7,464.54 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,464.54 ","$7,464.54 ","$8,584.22 ","$7,464.54 ","$0.00 ","$0.00 ","$28,983.49 "],["330104","","","","","","710","2","","","","Infectious & parasitic diseases including HIV w O.R. procedure","I","$0.00 ","$11,322.88 ","$0.00 ","$11,322.88 ","$0.00 ","$0.00 ","$0.00 ","$10,756.73 ","$0.00 ","$10,869.96 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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"],["330104","","","","","","711","1","","","","Post-op post-trauma other device infections w O.R. procedure","I","$0.00 ","$7,957.60 ","$0.00 ","$7,957.60 ","$0.00 ","$0.00 ","$0.00 ","$7,559.72 ","$0.00 ","$7,639.30 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,185.73 ","$7,957.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$8,196.33 ","$0.00 ","$0.00 ","$11,140.64 ","$30,972.94 ","$7,957.60 ","$10,742.76 ","$9,787.85 ","$0.00 ","$8,196.33 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,957.60 ","$21,303.45 ","$9,549.12 ","$7,957.60 ","$7,957.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,957.60 ","$7,957.60 ","$9,151.24 ","$7,957.60 ","$0.00 ","$0.00 ","$30,972.94 "],["330104","","","","","","711","2","","","","Post-op post-trauma other device infections w O.R. procedure","I","$0.00 ","$10,782.10 ","$0.00 ","$10,782.10 ","$0.00 ","$0.00 ","$0.00 ","$10,243.00 ","$0.00 ","$10,350.82 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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"],["330104","","","","","","720","1","","","","Septicemia & disseminated infections","I","$0.00 ","$4,286.81 ","$0.00 ","$4,286.81 ","$0.00 ","$0.00 ","$0.00 ","$4,072.47 ","$0.00 ","$4,115.34 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,487.12 ","$4,286.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,415.42 ","$0.00 ","$0.00 ","$6,001.54 ","$16,161.66 ","$4,286.81 ","$5,787.20 ","$5,272.78 ","$0.00 ","$4,415.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,286.81 ","$11,116.12 ","$5,144.17 ","$4,286.81 ","$4,286.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,286.81 ","$4,286.81 ","$4,929.83 ","$4,286.81 ","$0.00 ","$0.00 ","$16,161.66 "],["330104","","","","","","720","2","","","","Septicemia & disseminated infections","I","$0.00 ","$5,806.42 ","$0.00 ","$5,806.42 ","$0.00 ","$0.00 ","$0.00 ","$5,516.10 ","$0.00 ","$5,574.16 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,432.22 ","$5,806.42 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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","$0.00 ","$4,320.53 ","$0.00 ","$4,366.01 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,821.34 ","$4,547.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,684.36 ","$0.00 ","$0.00 ","$6,367.09 ","$17,215.21 ","$4,547.92 ","$6,139.69 ","$5,593.94 ","$0.00 ","$4,684.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,547.92 ","$11,840.77 ","$5,457.51 ","$4,547.92 ","$4,547.92 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,547.92 ","$4,547.92 ","$5,230.11 ","$4,547.92 ","$0.00 ","$0.00 ","$17,215.21 "],["330104","","","","","","721","2","","","","Post-operative post-traumatic other device infections","I","$0.00 ","$5,891.25 ","$0.00 ","$5,891.25 ","$0.00 ","$0.00 ","$0.00 ","$5,596.69 ","$0.00 ","$5,655.60 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$7,540.80 ","$5,891.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$6,067.99 ","$0.00 ","$0.00 ","$8,247.75 ","$22,635.41 ","$5,891.25 ","$7,953.19 ","$7,246.24 ","$0.00 ","$6,067.99 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,891.25 ","$15,568.83 ","$7,069.50 ","$5,891.25 ","$5,891.25 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$5,891.25 ","$5,891.25 ","$6,774.94 ","$5,891.25 ","$0.00 ","$0.00 ","$22,635.41 "],["330104","","","","","","721","3","","","","Post-operative post-traumatic other device infections","I","$0.00 ","$9,768.81 ","$0.00 ","$9,768.81 ","$0.00 ","$0.00 ","$0.00 ","$9,280.37 ","$0.00 ","$9,378.05 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$12,504.07 ","$9,768.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$10,061.87 ","$0.00 ","$0.00 ","$13,676.33 ","$38,280.98 ","$9,768.81 ","$13,187.89 ","$12,015.63 ","$0.00 ","$10,061.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,768.81 ","$26,329.99 ","$11,722.57 ","$9,768.81 ","$9,768.81 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$9,768.81 ","$9,768.81 ","$11,234.13 ","$9,768.81 ","$0.00 ","$0.00 ","$38,280.98 "],["330104","","","","","","721","4","","","","Post-operative post-traumatic other device infections","I","$0.00 ","$19,042.87 ","$0.00 ","$19,042.87 ","$0.00 ","$0.00 ","$0.00 ","$18,090.72 ","$0.00 ","$18,281.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,374.87 ","$19,042.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,614.15 ","$0.00 ","$0.00 ","$26,660.02 ","$75,700.94 ","$19,042.87 ","$25,707.87 ","$23,422.73 ","$0.00 ","$19,614.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,042.87 ","$52,067.75 ","$22,851.44 ","$19,042.87 ","$19,042.87 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,042.87 ","$19,042.87 ","$21,899.30 ","$19,042.87 ","$0.00 ","$0.00 ","$75,700.94 "],["330104","","","","","","722","1","","","","Fever","I","$0.00 ","$3,683.74 ","$0.00 ","$3,683.74 ","$0.00 ","$0.00 ","$0.00 ","$3,499.55 ","$0.00 ","$3,536.39 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$4,715.19 ","$3,683.74 ","$0.00 ","$0.00 ","$0.00 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","$124,463.91 ","$0.00 ","$124,463.91 ","$0.00 ","$0.00 ","$0.00 ","$118,240.72 ","$0.00 ","$119,485.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$159,313.81 ","$124,463.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$128,197.83 ","$0.00 ","$0.00 ","$174,249.48 ","$501,064.82 ","$124,463.91 ","$168,026.28 ","$153,090.61 ","$0.00 ","$128,197.83 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$124,463.91 ","$344,636.65 ","$149,356.69 ","$124,463.91 ","$124,463.91 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$124,463.91 ","$124,463.91 ","$143,133.50 ","$124,463.91 ","$0.00 ","$0.00 ","$501,064.82 "],["330104","","","","","","842","1","","","","Burns with skin graft except extensive 3rd degree burns","I","$0.00 ","$14,564.23 ","$0.00 ","$14,564.23 ","$0.00 ","$0.00 ","$0.00 ","$13,836.02 ","$0.00 ","$13,981.66 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$18,642.21 ","$14,564.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$15,001.15 ","$0.00 ","$0.00 ","$20,389.92 ","$57,630.05 ","$14,564.23 ","$19,661.71 ","$17,914.00 ","$0.00 ","$15,001.15 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,564.23 ","$39,638.44 ","$17,477.07 ","$14,564.23 ","$14,564.23 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$14,564.23 ","$14,564.23 ","$16,748.86 ","$14,564.23 ","$0.00 ","$0.00 ","$57,630.05 "],["330104","","","","","","842","2","","","","Burns with skin graft except extensive 3rd degree burns","I","$0.00 ","$19,065.40 ","$0.00 ","$19,065.40 ","$0.00 ","$0.00 ","$0.00 ","$18,112.13 ","$0.00 ","$18,302.78 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$24,403.71 ","$19,065.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,637.36 ","$0.00 ","$0.00 ","$26,691.56 ","$75,791.86 ","$19,065.40 ","$25,738.29 ","$23,450.44 ","$0.00 ","$19,637.36 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$19,065.40 ","$52,130.28 ","$22,878.48 ","$19,065.40 ","$19,065.40 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 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aftercare or oth contact w health service","I","$0.00 ","$21,735.49 ","$0.00 ","$21,735.49 ","$0.00 ","$0.00 ","$0.00 ","$20,648.71 ","$0.00 ","$20,866.07 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$27,821.42 ","$21,735.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$22,387.55 ","$0.00 ","$0.00 ","$30,429.68 ","$86,565.40 ","$21,735.49 ","$29,342.91 ","$26,734.65 ","$0.00 ","$22,387.55 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,735.49 ","$59,540.42 ","$26,082.58 ","$21,735.49 ","$21,735.49 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$21,735.49 ","$21,735.49 ","$24,995.81 ","$21,735.49 ","$0.00 ","$0.00 ","$86,565.40 "],["330104","","","","","","850","4","","","","Procedure w diag of rehab aftercare or oth contact w health service","I","$0.00 ","$50,824.79 ","$0.00 ","$50,824.79 ","$0.00 ","$0.00 ","$0.00 ","$48,283.55 ","$0.00 ","$48,791.80 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$0.00 ","$65,055.73 ","$50,824.79 ","$0.00 ","$0.00 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